MD Anderson recommends docetaxel and ADT with primary site radiation after. I see there's some data of maintaining better control with early chemo, but wanted to know if anyone else has experienced it. My urologist recommended ADT and IMRT to all sites. I'm inclined to have more faith in MD Anderson.
Any thoughts?
MD Anderson got it right.
Chemo and ADT to nail it. Radiation for clean up it usable.
I was treated with ADT upfront to lower PSA , Followed by 6 rounds of chemotherapy ( Docetaxil). Then 20 treatments of radiation to the prostate. PSA went from 105 to .02 with continued ADT.
And then?
I have continued with only Zoladex since treatments and now my PSA is climbing. Going to try another Oncologist and see what else we can do. PSA now at 0.26 ug/L from 0.02 ug/L.
My PSA remains <.1, but I've also started abiraterone and prednisone. I switched from firmagon to lupron, but have a orch scheduled in May. My oncologist says ADT for life and I figure why inject a chemical when a 30 minute procedure does the same.
What's an orch
I believe it is short for orchiectomy, the removal of testicle(s). ADT will cause them to atrophy and be of no use at all. So the choice is take a drug for the rest of your life or have them remove your testicles and don't take the drug. I had mine done last year and am so happy to not have to deal with Lupron. Life on the other hand is being a real b**** right now.
I don't get why most think ADT for life is necessary....many people take "vacations".... many PC cancers end up castrate resistant so why worry about testosterone levels at all at that point... I'm into a having a long life, but quality matters.
Speaking to my case (YMMV), my PSA never stopped rising after initially falling to 0.1 so a vacation from ADT would have not been wise. Also, as I understand it, you only go on ADT once the cancer is castrate resistant and since testosterone feeds the cancer, keeping it low helps slow the disease progress. My treatment had Lupron to suppress testosterone and Xtandi to fight the cancer. Now that I've stopped the Xtandi (no longer working, after many years) I am free of the Lupron side effects, too. My QOL (quality of life) has been quite good so far and I've outlived initial life expectancy, which is why I am not so sure about doing chemo for 7 months just to gain a couple of months more of an unknown QOL.
My information is since I had lymph and bone involvement her thought would be ADT for life. Injecting a chemical for life instead of simply having a 30 minute procedure doesn't make sense for me. At some time ADT vacation may be available, but maybe not in my case and if need be I'll use a patch. 
Today seems like the second time I've seen the Tax-127 trial info.Did you realize that it resulted in:
compared to no Dox chemo, Dox chemo added 18.9 months PFS.
Compared to no Mito chemo, Mito chemo added 16.5 months PFS.
So it looks like many can get at least 19 months out of Docetaxel.
And it might "re-sensitize" ones cells so that Xtandi, or Zytiga works again.
ADT+docetaxel first impressions, adding darolutamide
Looking for others with stage III on ADT
Salvage radiation vs ADT and zytiga for stage t3b
4 Months ADT or 6 months. 
