iADT or cADT after 3 month Casodex.

[Odon]

Age 66. RRP in 2014. G 3+4 PSA 5.17 T2c, negativ margins.

PSA slowly increased 0.32 in 2017 having SBRT, PSA dropped at 0.19

Untill 2020 increased again to 0.62. PSMA Ga 68 negativ

June 2020 started Casodex 150mg, Tamoxofen 50 Mg.

After 6 weeks PSA 0.089, after other 6 weeks PSA 0.049

What next?

MO adviced 6 months Casodex and reevaluate after.

My question: should I continue without Holidays (for how long) , or have Holidays (for how long)?

[Tall_Allen]

Your PSA is still very low. I have a question - you wrote that you had SBRT as salvage in 2017. That is unusual. What was treated?

[Odon in reply to Tall_Allen]

2017 rising slowly until 0.32.

PSMA PET/CT Ga68 found "maybe" a small lymph node metastasis but not clear, and a tiny focus at the bifurcation of the right iliac vesels.

2017 I got 7 SBRT radiations for these 2 points.

[Tall_Allen in reply to Odon]

That is indeed strange. So you never received radiation to your prostate bed or your pelic lymph nodes as a whole? Maybe it's time you did.

[Odon in reply to Tall_Allen]

No, it was recommended SBRT at those 2 points. Can I have after SBRT, radiation to the prostate bed or to the pelvic lymph nodes as a whole?

[Tall_Allen in reply to Odon]

Probably. Maybe find a different radiation oncologist.

[Magnus1964]

I have never been a fan of intermittent ADT treatments. By stopping an ADT drug you run the risk of the next cancer cell line becoming resistant to the drug.

[doc1947g]

So it seems that his PSA never when to undetectable level like 0.03 ug/L as a NO prostate should be.

I am VERY lucky, I am 73 y.o. with G(4+3=7) Grade 3 UIR on ADT for 6 months. My PSA = 0.03 ug/L. Even my RO was impressed.

[Odon in reply to doc1947g]

After surgery in 2014 was 0.003, and after it slowly in 2017 reached 0.32.