I had RP (2001) with Gleason 3/4, clean margins. Dx'd with biochemical recurrence in 2015 leading to 45 sessions of salvage radiation (MRI was normal) and PSA was 0.40 at start of salvage tx. Nadir of 0.11 leading to peak of 0.63 with 5-6 month DT when I entered a clinical study (phase 3) ending up on the "control" arm. Receiving monthly ADT "depot" injections since October 2018. PSA declined sharply (0.10 after one month, 0.01 last month). I will be getting my 8th injection next week. Scans before starting were clear (bone, CTs chest, abd, pelvis) except a possible mets in a pelvic wall lymph node. So I see myself as low volume, low risk, stage 4? without definite site (assumed, not in the pelvic bed due to radiation, and of course no prostate).
My question is should I drop out of the study? I have consulted 2 MOs and a Urologist from a large practice who specializes in Ca. One stated their approach in my case was 9 months of ADT, then holiday; another stated 6 months tx and if working a holiday, and the third said they would stop after a good response, and await an upward PSA value to signal end of the holiday. Bottom line no one recommended 12 months of ADT as the study requires. I appreciate that the study was designed several years ago, and SOC has changed. So while I hate to leave the study (always a good soldier), yet continuing tx seems to be risking harm (remote) for no benefit as the study will be comparing a control that no longer is SOC. My current QOL suffers with frequent hot flashes, difficulty sleeping, significant fatigue though I do continue shorter runs and weight lifting, fuzzy brain. My sense is to start that holiday, but can't find a good consensus on when. Should I leave the study?
I do really appreciate all the information you all share on this site.