Starting ADT

[sinned1972]

DX April 2019, 46 years old. Gleason 10 in 11 of 12 points. Mets to lymph nodes. Current tumor board treatment plan is robotic RP in July and external radiation as soon as I feel urinary symptoms have subsided. The tumor board did recommend starting ADT right away, but waiting until prior to RT to begin. My RT OC is suggesting starting ADT ASAP, just because it can’t hurt. At the RP surgeon appt today he shrugged his shoulders and said he was part of tumor board and they decided there is no data to support starting ADT this early, but I can do it if I want. My thought is if nothing else, it would slow any potential further spread to bone or other key areas. Thoughts?

[tkalaf]

Yes. In my thinking I would start it right away. If for nothing else, it should slow cancer growth making the region 'quieter' before and during your surgery. (Now understand, I am not a medical professional and that I'm only speaking from my patient experience.)

My RP was almost a year ago, June of 2018. I went through a heavy course of ADT & HT medicines neoadjuvant (pre-surgery), as part of a clinical-trial. Now almost a year after surgery, I feel these medicines played a big part in treatment. I would even go as far as they may have held back my cancer becoming metastasized. Let me explain (again, from a non-professional viewpoint) ...

My diagnosis from biopsy and scans placed me as non-metastatic. However my diagnosis from RP surgery (pathology results) indicated cancer was found on the prostate surface, or extra-capsular. I sincerely feel these medicines shunted and/or held back any spread of my cancer from gland to lymph nodes (or wherever), until the time I could get it removed.

I get a PSA test now every 3 months, and am fortunate to report they all have come back measuring below 0.03 threshold! You've come to a good site. You will find many here that can help you with information, possibly answers to many questions you have. I wish you the best!

[Chugach]

I too was diagnosed at 46 Gleason 9/10. Start ADT!!!!! if it’s in the lymph why do surgery?- do radiation (same with me+ chemo.) Be sure to get an MRI CT and bone scan to get the full picture before the get you on the surgery table.

[sinned1972 in reply to Chugach]

Surgery is to alleviate urinary symptoms. Urinating is extremely uncomfortable. Extreme urgency when it’s time to go, difficulty starting urination once in there, lots of dribbling and pain during urination, unable to completely empty my bladder (200 units left after complete emptying). Urologist feel my prostate is causing an extreme blockage and surgery is necessary to prevent further bladder issues.

Bone scan showed possible iliac condition but very slight. CT scan showed metastasis in lymph’s near prostate and colon, but very slight.

[jkm100]

46 as well! G8, 10/10 with clear bone scan and CT. As soon as I went beyond my urologist to a leading RO, I was put on ADT immediately. Need to do some bloodwork and MRI this week, then HDR brachy near the end of July. EBRT to follow a couple of weeks later.

Other than a shitty flow, I don’t have the extent of urinary problems you do.

RO’s did say the ADT will aid in reducing prostate size and slow/stop progression.