ADT vs Castration Should I hold off.

[farm15]

Hi Gang, Just hoping to get feedback on the pros and's cons. Considering castration. I am going to turn 58 in December March 2020 will be five years in the fight.

Farm 15

[Tall_Allen]

It depends on whether you will be doing intermittent ADT or continuous.

[whatsinaname]

IF you get castrated, you might get remission for a year or two. What after that when your PSA starts rising ??? Start second line ADT like Abiraterone or Enzalutamide ???

[farm15 in reply to whatsinaname]

If PSA rises would I then be CRPC?

[whatsinaname in reply to farm15]

IF, your PSA rises after taking ADT medication AND your testosterone levels are below 20 or thereabouts, yes, THEN, you are considered to be "castrate resistant".

[farm15 in reply to whatsinaname]

Thanks

[whatsinaname in reply to farm15]

Most welcome, farm15. Cheers and all the very best to you !!

[farm15 in reply to whatsinaname]

Likewise!

[tango65]

ADT is usually reversible. Castration is permanent. One can argue doctors could give you testosterone to have a normal testosterone value after having castration if you want to do intermittent ADT. In my personal experience is very difficult or impossible to get a doctor who will be willing to give testosterone to a patient with PC.

[pjoshea13 in reply to tango65]

My integrative guy gives me T.

I know that Morgentaler has prescribed T.

&, of course, there is Denmeade's BAT studies at Johns Hopkins.

-Patrick

[farm15]

Thank you guys very much.

[Magnus1964]

At your age I might consider the orchiectomy. This could give you years of quality life with radiation and ADT drugs.

[farm15 in reply to Magnus1964]

Thank you.

[Hidden]

Your decision. Understand the ramifications. I am glad that I did not follow that path; preferring to managing any and all side effects. Good luck.

GD

[farm15 in reply to Hidden]

Thank you just thinking it would be more affordable than years of various ADT drugs. And the issue of having to work to keep insurance. But if cancer becomes CRPC then there is no turning back. Does this cancer eventually become resistant or are there cases where you are ADT for life? Thanks for letting me rant. My gleason was a 9.

Thanks Farm15.

[Hidden in reply to farm15]

I did not know that Medicare and Supplemental did not pay for treatment. I was on Lupron/Eligard from 2004 to 2010 when I had metastatic PCa. I took a non-standard treatment six-month clinical trial upon DX of distant bone mets. Good luck killing the bastard.

GD

[farm15 in reply to Hidden]

Thank you. I should made it clear I started this journey at 53 I will turn 58 and I find it harder to work on ADT. I'm told I can not get Medicare until 65.

[Hidden in reply to farm15]

I retired at 63. As soon as I turned 65, I was booted from the retirees health care plan upon eligibility for Medicare. I never took disability....

[Sxrxrnr1 in reply to farm15]

Given your status, you may easily qualify for Social Security Disability. I suggest consulting with an attorney that specializes in this,,,,there is no charge unless you win and this fee is limited to about 6K.

Once on SSD you are deemed Medicare eligible after 2 years, regardless of your age.

There are a couple of recent threads on this exact topic posted to this forum.

Perhaps others can post links to these threads,,I have not quite figured this out,,or you can search for social security disability for them.

[farm15 in reply to Sxrxrnr1]

Thank you so much .I will look for the threads.

[Hidden in reply to Hidden]

hello gourd dancer, I just read your above post from a few years back. Will Medicare not pay for ADT treatment? I’m 62 and plan on retirement st 65. If this is true, I’ll have rethink my strategy.

Thanks

[j-o-h-n in reply to farm15]

Yes, Yes and Yes.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/12/2019 6:21 PM DST

[farm15 in reply to j-o-h-n]

Thank you j-o-h-n.

[sandbergc9]

Sorry for the slow reply. My personal response to learning about my stage 4 was to say : "if you want to reduce the testosterone, let's remove the glands causing the problem"

10 days later the dirty deed was done! Castration! Shh don't tell anyone! PSA dropped to zero, mets disappeared!

I am a lot calmer, less likely to argue and sing like an alto! LOL!

My decision was based on being able to work as long as possible to get my kids thru college! (financial in my life)

Anyhow I've had good luck so far. Still on the Zytiga/Predisone. PSA still < .01 undetectable! Bone scan last month - No Metastatic disease! 19 months since the Orcectoamy Sp?!

Best of luck

Cheers

[farm15 in reply to sandbergc9]

Thank you for sharing.

[CSHobie in reply to sandbergc9]

Sandberg

Thanks for the sharing.

I am 52, and was diagnosed in Jan 2020, started ADT Eligard Injections and Zytiga/Prednisone in March 2020.

In the last month or so I have constant headaches. I am thinking it may be due to the Eligard/Luprolide injections.

Do you have any headache issues with the Snip?

[Shooter1]

17 mo. after snip/snip. Cancer in remission/ T at less than detectable. At 68, better choice for me than ADT drugs for life. Gleason 9/10 mets in bones and lymph modes at DX.

[farm15 in reply to Shooter1]

Thank you for sharing your story.