So, 8/2019 had RP, PSA 8.6, GL 9, T2N1M0, Decipher High - got to undetectable in 6 weeks...then a slow rise over a year to PSA .16...started ADT - Firmagon 10/2020, switched to Orgovyx 2/2021...PSA went to undetectable almost immediately on Firmagon...has stayed there and T stays in teens. 1/2 way through 38 sessions of SRT. Will 2 years of ADT be the shortest period I can expect for ADT? What should determine the length of ADT therapy?
Thanks all...safe journeys to everyone.
in my case while on ADT+, 06/06/19-PSA 0.02, 07/19/19-PSA <0.02, as of last blood draw: 02/18/21-PSA <0.02...
So, this undetectable 20 months trek was holding with T levels of <3 ng/dL, skipped my 02/18 Lupron shot and stopped taking Abiraterone.
At this point of my ADT+ vacation, when will my T start increasing for the benefits? Why wait for natural T recovery and start testosterone replacement therapy immediately? Obviously, my cancer is hormone sensitive, why tempt the devil?
Like Nalakrats said, we're all different and nobody knows what my cancer will do, an experiment of one...
2-3 years of ADT for N1 is normal.
If it's working and side effects are tolerable why go off it.
The effects of low T...lethargy, muscle and bone loss., loss of libido, the interminable hot flashes. But I see the point of keeping the wolf from the door. Thanks.
I was N1 - node positive with G9 (PSA 180 +) as well nearly 4 years ago. I also got to 'undetectable within 1 year after radiation and ADT.
I QUIT ADT after 16 months - went on a 2 1/2 year holiday - and had a BCR - so I'm back on ADT again and hope to cycle on it.
N1, unfortunately is probably showing signs of 'micro-metastasis in the NODES themselves.
A PSMA/PET scan could find the PSA source >= 0.2 once you've quit ADT and start to have a rise - otherwise, you won't know until then - after finding out IF you still have 'cancer' after the primary treatments.
That's what 'got me back' - BCR - I was told that 'maybe' I might be in long term remission, but the odds are 50% against - no need to panic, BUT you probably should consider 24 + months that will likely be advised - I'm no doctor but you need to give ADT time to give it your best shot at beating the odds IMO.
Others may weigh in on this one ....
My opinion: RT causes lethal DNA damage to the treated cancer cells. But they do not "die" until they go to divide. PC can be a very slow growing cancer, which is why it can take years to reach a true nadir. The ADT severely impairs the cancer cells, so they have less chance of surviving if ADT is present when they try to divide/replicate. So that is why 2 years ADT makes sense.However one good study showed that may only apply to those with higher PSA values at the beginning. Your PSA would suggest that perhaps 6 months or one year might be adequate. But with a Gleason of 9 I personally would opt for the more aggressive 2 years.
Thank you. I had not seen the actual process reduced to such a simple concept....that makes perfect sense...and helps with maintaining the mental perspective to get through this period. Thank you! I really appreciate your feedback.
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