I am wondering what the time is from starting ADT (Eligard, Lupron, degarelix, etc.) till the PCa becoming castrate resistant. I read a recent post from “whatsinaname” where his failed after only 6 months. Is that an outlier on the short side, or typical? I realize there is much individual variation. Can anyone provide some perspective on this? Thanks!
Time to ADT Failure: I am wondering... - Advanced Prostate...
Time to ADT Failure
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6357axbz
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12 to 24 months with traditional ADT. With new studies and the addition of zytiga, the new norm is around 2 years. That's from the few studies that i have read that have come out late 2018 and early 2019. Failure at 6 months is not the norm and is extremely short.
Things like gleason score, number of mets, type of prostate cancer and PSA Nadir are important.
I have heard that some folks stayed on adt for more than 15 years. I can’t make an informed decision about this. Some people has been on adt since late 1990. and others only 6 months. These statistics drive me crazy as I am about to start adt.
Also, I just read through "whatsinaname" and it seemed that no treatment was very effective for him unfortunately. Chemo or ADT. So hopefully his next line of treatments are extremely effective.
But it's also really difficult to tell anymore because so many men are getting different treatment. Some are getting RP with metastatic cancer and that was extremely rare even 3 years ago.
An important indicator from what I have read is going to be your time to PSA Nadir and how longs it stays there. Getting your PSA to < 4 by month 7 indicates a good median response and getting it to < 0.2 represents a great response and has the best indication for survival.
However, I've read guys stories on here that have never even reached a PSA <4 and have lived for years and years and years. It's the problem with this POS disease, it's so wildly different for everyone.
But I would really go with the 18-24 months with the new standard of care.
Good to read, got my initial 1386 PSA in Nov down to 4 PSA in 3 months, It was a scary number at first, your comments gives me hope
For me, 18-24 months to death after diagnosis, I think.
I am at 20 months now 
I am not in the least bit scared.
When you gotta go, ya gotta go
Go calmly, peacefully, cheerfully.
My dad has been on Lupron since June 2015. His last PSA was .07 down from 257 when he was diagnosed in 2015. He also had six rounds of chemo initially. He’s responded incredibly well to it in my opinion!
Thanks Lynsi. That provides some hope.
It's different for everyone. I got 5 years out of casodex, and 3 1/2 years out of zytiga and xtandi. I realize these numbers are unusual but it shows how each of us is different.
Did you start with casodex by itself or in combination with something else?
It was casodex alone.
Good for you! Hope it keeps going that way
I was diagnosed just under one year ago. I have done Lupron, Zytiga and 6 rounds of Taxotere. My psa kept rising during chemo. Yesterday MO told me I am effectively castration resistant. He wants me to do a trail with Xtandi and Cabazitaxel combined at the same time. Sucks!
Hex40• in reply to
Where is this trial and what is it’s title?
• in reply toHex40
Julie GraffIRB00011227VAPORHCS/OHSU J: A Phase I/II Trial of Concurrent Chemohormonal Therapy Using Enzalutamide (MDV-3100) and Cabazitaxel in Patients with Metastatic Castration Resistant Prostate Cancer.
I found the above on the OHSU Knight Cancer Center site. I got in via SCCA in Seattle.
• in reply to
Belive in it and don’t look back . It could save you ..
• in reply to
You are right and I need to stay with that attitude.....it slips on occasion!
They have stats. Dont gauge your future on those.. Don’t predict bad . Some have gone decades... Each one of us is different . 5 months , 5 yrs , no one knows for sure . Not even the best doctors .. The better you treat yourself the better odds of extended life.. I’m just saying this because I’ve had over 3yrs clear now ..Still on adt . Truth be told the ugly APC pendulum can return its swing on us at any time. Point is to enjoy the here and now . They told me I’d be dead already , now nobody is saying anything. My less informed non pc specialist jokes “ you’re cured”. A cure may come. There isn’t one yet . Miracles happen . We all want to be “that guy “ that breaks the odds and those dam dismal stats. Do all that you can . Increasing your odds . My uneducated opinion only . I think you can do better than stats .. If you don’t bite ito them ... If you say to yourself I’m going to die in 24 months like they say , you just might. Don’t get me wrong. When an aggressive APC sinks it’s teeth into us for its final course, Death will be a welcome mercy for all. Until then keep kicking .. the psychology of living with a treminal disease such as APC can whittle you down emotionally if not careful in practicing daily happiness and healthy routines . Do anything to take your mind off of PC daily..
Firespooks• in reply to
Well written. Thank you. I don’t believe it when I hear someone that says they’re cured. I always say Cancer is in remission. Happened to me 2 times. Now the little bastard is back again 🤬🤬🤬
• in reply toFirespooks
APC is Tenacious and long winded . A battle of attrition .. Our first rounds are a sprint to survive . One fine fellow has been at this for 23 yrs of a heavyweight fight .ask Magnus 1964...23 yrs later still sparing with our little friend .. Cure , I think not . A life of contention with APC if one is lucky ..Enough to pass the first rounds . We must work hard to live alongside our nemesis. Giving up is sure death.. keep fighting brother... that’s all that anyone can do . No one has APC figured out. If they did , we wouldn’t need to be here talking about it. Carpe diem
• in reply to
We must be tenacious and long winded to endure .. Im obviously long winded , working on the tenacity ...
ITCandy• in reply to
I recall Eric (cericwin) liked to call it APC, stating that PCa made an advanced case seem less serious. You should come out of retirement and become a motivational speaker. You have a gift for it.
• in reply toITCandy
I have not seen any one use PCa in my case . It’s always APC once #4 .. So gracious of you to say such kind words. I’ve been following philosophers for motivation . One favorite is Mark Twain “ The best way to cheer yourself up is by cheering someone else up “. There is plenty of gloom circling this cite , plenty of misery for all to be had . If i don’t laugh it off , uncontrollable crying might then exist . Selfishly I’m just trying to keep my head above water.. Us APC passengers just tow the line and tote this bale as long as we can . Try not to go down in bitterness and self loathing. Been there done that . Destructive to all. I remember Flip Wilson “ Here comes the judge!” The judge is APC and the ball is in his court . We are all guilty as charged.. but if we can’t poke the “ judge in the eye along the way he gets the last laugh. life is dismal without appreciation of the irony and comic tradgedy of living with APC .. If we can’t appreciate each other’s plight why are we here on HU .. strength in compassion and numbers .. Have a great day .. and a fine weekend .. ITCandy
j-o-h-n• in reply to
Mark Twain “ The best way to cheer yourself up is by cheering someone else up “.
Shit.... He copied my line. As far as I'm concerned no Mr. nice guy for me since the twain has left the twasion.
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 03/08/2019 5:36 PM EST
• in reply toj-o-h-n
How Twaint!
j-o-h-n• in reply to
You're going to make me faint....
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 03/08/2019 11:32 PM EST
• in reply toj-o-h-n
Taint either .
j-o-h-n• in reply to
You ain't a Saint...
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 03/09/2019 12:08 PM EST
This issue has always surprised me with the ancient canard of 2-3 years. I endeavored to discover the origin of this time span. These are the significant trials/studies that set the standard for time-to-resistance:
Leuprolide With and Without Flutamide in Advanced Prostate Cancer,
E David Crawford. Trial started 1985, accrued 1986.
Progression free survival median was 8.5 months in greatest disease, 17 months in mid level disease group, and 55 months in minimal disease (minimal, mid and severe). 1 mg/day, daily dosing. (Current is 7.5/month)
—————————————
ncbi.nlm.nih.gov/pubmed/751...
Early androgen ablation for stage D1 (N1 to N3, M0) prostate cancer: prognostic variables and outcome.
G. K. Zagars, 1994
179 men with Node spread, mild to extensive; castration, surgical or chemical, and at 5 years 55% still responding
For those whose psa became undetectable (<0.1) 80% responding at 7+ years
No Prostate treatment
—————————————————
nejm.org/doi/full/10.1056/N...
Immediate Hormonal Therapy Compared with Observation after Radical Prostatectomy and Pelvic Lymphadenectomy in Men with Node-Positive Prostate Cancer
1988-1993 Messing, E. Et al.
At 7+ years median follow 36 (77%) in treatment group and 9 in observation group had no sign of disease. 3 men in treatment group died of PCa and 16 in observation group died. The rest of the observation group had relapsed or progressive disease.
Update in 2006 after median follow of 11.7 years intervention group was ~60% alive and no recurrence.
——————————————————-
academia.edu/19426354/Contr.... 1992
Crawford, E. David, et al
This is the source of the 24-36 months term for successful hormone treatment based on 50-60% of patients with advanced disease AT DIAGNOSIS (my emphasis).
The key is that in the far distant past, when men were most likely diagnosed with distant spread of disease, the patient response to the drugs used at the time were related to: disease burden, response to treatment (lowest psa), and after treatment of the primary site. Note that these trials predate psa use or are from the early(est) psa period. Medical texts written in late 1990-early 2000 period would have been basis of doctor training for those in their professional practice today. For those who do not stay on top of changes in their field they may still be unfamiliar about what has changed since their medical school days.
• in reply totarhoosier
Great job . Go hooosiers! Spent a few years around Bloomington my self.. be well tarhoosier!
That is an interesting idea to help predict the aggressiveness of the disease. My husband went CR about two years on ADT. Although I think he might have squeezed a little more time from Casodex. I was surprised and hesitant to add Xtandi as soon as the doc suggested it due to side effect.
My husband has 18+ years of treatments and must have slower and lower disease volume according to your cited study as well as some luck.
• in reply toGrumpyswife
Luck is a factor .... 18 yrs gives much hope , especially to young newbies suffering fear of instant death.. 👏 nice sunset and smiles too. Thanks
whatsinaname• in reply to
LUCK is the ONLY factor.
That is the conclusion I have come to after much deliberation.
I consider myself lucky that I was not detected 15 years earlier.
And, that those 15 years were simply superb for my wife and myself.
Of course, I would have preferred to have been detected at 75 or later.
Or, never at all. If wishes were horses........
I was recently reliably informed by a reputed onco that regular drinking of cow urine and eating cow dung could CURE MPC.
Why not DONKEY urine or HORSE urine ???
No answer. Perhaps, the COW is their freakin GOD ??
As I’m now at 7.5 years after a dx PSA of 571 and seven major bone Mets, I would say it’s impossible to say with any certainty.
I’m in the STAMPEDE trial on Zytiga with Zoladex, which reduced my PSA to immeasurable within 12 weeks, where it’s stayed. Others on exactly the same regime became CRPC within as little as 12 weeks.
Depends on your particular gene profile I suspect.
Thanks for responding. We’re you on stampede trial from time of Dx or did you start later? If later what was your initial treatment?
Hi
I was immediately given Casodex for 2 weeks, and was asked to join the trial after that. Initially I wasn’t given a biopsy due to the high PSA and multiple Mets, however I had one so they had genetic material and a Gleason for a baseline.
Cheers
• in reply toTommyTV
7.5 is. Great... keep trucking TommyTV... by the way , have we seen you on TV ?
TommyTV• in reply to
No, but I worked in UK tv for many years. My company, Vector Television, made programmes like The Royle Family. Lots of pop videos including Take That, the biggest U.K. ‘boyband’. Worked on Reading Festival a couple of times, The Royal Wedding for German TV and so on. So I’m not a cross dresser😄.
• in reply toTommyTV
That is an interesting carreer . “Take That” Must have been some good times. Monty python crossed dressed enough for us all. Long live the Queen . The royal family thanks V.T. And I thank you tommmyTV for giving me a glimpse of a fantastic life. Take care👑
I tell everyone I know. They spend billions of dollars to see if there is water on Mars and yet they can’t cure cancer down hear on earth. Something is wrong with that picture !!!
And endless wars. And the War on Drugs. Anything that squeezes out overtime pay. Follow the money. The yellow brick road is paved with gold.
• in reply tomonte1111
With no geological training I just saw that all gold on earth came from outer space. How ironic that this precious commodity the source of most wars on earth is not even of this world. . We’re leaders in prison industries and weapons production ..This is governmental capitalism at its best .. For the people by the people is not currently accurate ..
monte1111• in reply to
Well, raise my rent. All gold comes from outer space? I was really thinking that Lulu700 was taking too many supplements. But google agrees with you, sir, and I apologize. I shall never doubt you again. Enjoy.
• in reply tomonte1111
You’re correct . I am taking too many supplements .. at least I’m not R Kelly
believe it or not cancer is more difficult because there are millions of different permutations. actually more because there's multiple permutations for each human being. there's probably only one way to get to mars.
• in reply toBreak60
Musk is going
These studies were all of men newly diagnosed, not after some years of surveillance or other treatments without hormone lowering drugs.
initial diagnosis Sept 1999. Treated with IMRT radiation then seeds. Recurrance in Oct 2011. Put on lupron and casodex. On a year, off a year. Still doing fine and am not
castrate resistant yet. I have been blessed. Every one is different. Good Luck
• in reply toJoeym1040
10-4 Joeym.......... you are blessed .... inspiring really ... thanks
It's answer is reached scientifically, toss a coin. Odds are 6,357 to 1.
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 03/08/2019 5:41 PM EST
• in reply toj-o-h-n
Flip of a coin ... that puts it into perspective
FWIW, which really isn't much, I am about 7.5 years into the fight. I had a RP done in Jan 2012 after diagnosis in Nov 2011 at age 66. My PSA dropped to 1.9 and the put my on Eligard. It quickly went to undetectable. The suggested a vacation. First PSA was 1.2, the next was a little over 10. Doubling time around 2 months I think. So I was put back on ADT, Trelstar this time. Back to undetectable at next measurement.
Moved to Pensacola and got all new doctors. After I got there I stayed on Trelstar, until my Uro and my MO put me on Xtandi as a secondary blockade. I had to cut that back to 2 pills a day from 4 and still have to sleep too much. But I remain <0.01. So...
Those longevity stats do not apply to everyone equally. I have been VERY fortunate so far, and give thanks to God every day. Ignore the stats. Every PCA fight is personal, and different. Find the best doctors you can, ones that you get along with. Stay in shape, eat well, and ENJOY LIFE!
- Marshall (Beerman)
• in reply toBeermaker
Gratitude and ignore the stats ... continued success Marshall ...
Thank you Marshall for your thoughtful response! Means a lot tome.
Hell yah Bill , Chuck Berry rocked around the clock.. he knew something , he knew the guitar ... what song was that in ? If we think we know it all we no nothing.
I’ve been on intermittent since 2014; so far so good.
And I’m Gleason 9 stage IV. 😅
• in reply toBreak60
One year and one Gleason number ahead of me .. good luck forward
I agree with you, Bill68. NO ONE KNOWS.
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