Let me preface this post by saying that I’m one of those guys who values quality of life over longevity, within reason. I know this stance is very controversial on this forum, and so I will tread lightly. Almost all of you guys are fighting tooth and nail for your last breath, and I respect that.
That said, I am having a difficult time coming to grips with the idea that I might have to or should go back on ADT for the rest of my life.
First, a little background...diagnosed on 1/18, RP in 8/18, salvage radiation from 3/19-6/19, ADT from 3/19-12/19, PSA returned on 1/21. And every imaginable scan or MRI has never been able to locate the source of my persistent PSA.
My PSA is currently at .9, with a 2.3 month doubling time. and I am scheduled to see my MO next week.
Now, obviously the safest move is to go back on ADT, but I had an extremely difficult time on ADT the first time around. It made me an emotional wreck and ruined my romantic relationship. Additionally, I had an heart attack on 8/20, and I know ADT can further damage one’s heart.
My MO says there is still a reasonable chance the sources of my PSA could be local (cells left behind in the prostate bed) and could be treated with radiation. Although I wonder about that theory, since my entire pelvic region was blasted with 40 doses of IMRT in early 2019.
So my question is, is it completely irresponsible to wait until the source of my PSA can be detected, and try to treat the source with targeted radiation? Or should I just capitulated and go on ADT indefinitely?