Partial ADT holiday looking for advice

[ReMarcAble]

Started Xtandi and Lupron a year ago. PSA went to undetectable almost immediately. MO and I agreed to take a 6 week Xtandi holiday but continuing Lupron. I'm uncertain as to the wisdom of this draw down however 4 days in to life without Xtandi I'm hoping for improved QOL. Blood work scheduled in 6 weeks. Many believe not to change things that are working........ I'm kind of excited but yet nervous at the same time.

[tango65]

I am not aware of information about intermittent enzalutamide plus ADT. The trials were done with continuous treatment. Having say that, your PSA is undetectable and the pause will be for 6 weeks..

[Boywonder56 in reply to tango65]

Imho...u stay course with lupron...vacation enz. Watch bloodworkd......lupron does the heavy lifting......dont quit it ...till it fails .....if stg 4

[tango65 in reply to Boywonder56]

He is going to stop xtandi only, he will continue with lupron.

[Boywonder56 in reply to tango65]

Damn lupron reading comprehension has taken a vacation....thanks tango

[London441]

What improvements in quality of life are you hoping for exactly? Whatever they are, you might get some by stopping the Xtandi but probably not much If you’re still taking Lupron .

How are your exercise habits?

[ReMarcAble in reply to London441]

In the gym every day except on golf days. Also paddle boarding and enjoy my pool. Lots of dog walking and biking as well

[GP24]

A holiday of six weeks will not make a significant difference.

You may ask your MO if you could stop Lupron for six months and just continue with Xtandi 🙂. This will make you feel much better. Lupron causes a lot of side effects.

[ReMarcAble in reply to GP24]

I like that idea. One reason for this Xtandi break was to possibly switch to Zytiga if/when my psa begins to rise. My understanding is that Xtandi can work after Zytiga fails where as Zytiga won’t work after Xtandi. Also not as important but generic Zytiga is so much less expensive than Xtandi.

[GP24 in reply to ReMarcAble]

There is a cross-resistance between Zytiga and Xtandi. If you start with Zytiga, Xtandi will work for about three months following that. If you start with Xtandi, Zytiga will work for a few months following that only. It seems that Zytiga followed by Xtandi works a bit longer thant Xtandi followed by Zytiga.

You MO will not agree to my suggestion. The advantage of that is that Xtandi monotherapy will not lower testosterone. One forum member managed to get an Nubeqa monotherapy which also does not lower the testosteron level.

[London441 in reply to ReMarcAble]

What was your testosterone before Lupron? Six months off Lupron may not make a significant difference either. It exits the system slowly.

I was on it for a year and felt no different until around 8 months. T was below 50 the first 4 months, then to the 100-130 range a month later, 250-500 soon after that.

Some men feel it sooner to be sure, but my case is more or less typical. Some don’t get back significant T at all, some it takes a year or more.

Some say they are feeling great a few days or weeks after stopping, but that is almost certainly psychological.

If I were you I’d try to get off it too, but not with a specific length set. Instead I’d let how much and how the fast PSA rises as T returns point the way.

Have you considered a switch to Orgovyx, should you decide to resume ADT after a holiday, whatever the length?

[chips1942]

Since each man’s PCa is different it is difficult to discuss any type of vacation. The recommended 4 week vacation from from Enza is a unique approach without knowing your cancer history or the doctors reasoning. I’ve been on adt on 3 times & with Enza 2 times. I felt no appreciable difference in QOL after stopping Enza even though the Lupron remained in my system for several months. I’m sure you know the 2 drugs have different mechanisms of action which could benefit your treatment. Certainly, ask your doctor what his plan is for your future treatments. Perhaps it would be valuable to have a broader discussion of vacations on this site. In my case, I’ve chosen to take vacations on two occasions based on my individual circumstances. Currently, I’ve been on a vacation for about 1 1/2 years, carefully watching my PSA, Testo & using psma & ct scans to gauge any changes.