I am on day 30/34 of IMRT Salvage Radiation. I started Bicalutimide just prior to starting Leuprolide Acetate back in November. I have tolerated the ADT treatment fairly well with minimal side effects. A Decipher test was performed midway through this per my request and my Decipher score came back 0.71.
Prior to this my RO and I had had discussions about a 4 month run vs.a 6 month course. Since my Decipher puts me a high risk for metastasis/death within 5 years we decided it would be prudent to do a 6 month run of ADT as long as I was tolerating it ok which I am.
I messaged her that I had no more Casodex refills on the prescription and she stated that "the convention has been to prescribe the Casodex for only 4 months irrespective of length of hormone therapy (2 months before RT, 2 months during RT)" I was not aware of the issue of stopping Casodex at this particular juncture.
Thoughts? I cannot seem to find much data as it relates to stopping Casodex, but continuing on with Lupron. In January I was <0.03, which the lab at the Hospital in which I am being treated is considered undetectable.
Also, I had asked about checking my Testosterone level as I would like to have an idea what my nadir is prior to stopping ADT in two months. My last Testosterone level was 431 on October 9th, 2019 prior to starting ADT. Her response was, "Also, I don't believe there is value in obtaining the testosterone right now. The hormone therapy is medical castration and hence will bring your testosterone down. In addition, your PSA has responded appropriately."
I actually would like to know what my nadir is, as some of the research I have done shows a low Testosterone of <0.7 is "predictive of improved cause-specific survival and prolonged time to hormone resistance."
Thank you very kindly for all of your wisdom. I greatly appreciate it!