Next treatment : At age 73, had robotic... - Advanced Prostate...

Advanced Prostate Cancer

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Next treatment

lhall2 profile image
11 Replies

At age 73, had robotic prostatectomy in March 2020. Gleason score of 7 (4+3) & grading of T3N1M0. Subsequent ultra sensitive PSA of 0.028 & 0.026 and testosterone level of 469.4. Received 40 sessions of whole pelvic radiation in April-May 2021 and 6mos Eligard injection. Post radiation ultra sensitive PSA of 0.014, 0.006 & yesterday 0.014. Testosterone levels of 3, 8 & yesterday <3. Scheduled to receive another Eligard injection next Tuesday. Any thoughts on Eligard duration & criteria for AS would be appreciated

Thanks

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lhall2
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Tall_Allen profile image
Tall_Allen

With N1, 2-3 years of ADT are required. Evidence from STAMPEDE this week shows benefit of added abiraterone.

lhall2 profile image
lhall2 in reply toTall_Allen

👍

StayingOptimistic profile image
StayingOptimistic in reply toTall_Allen

TA, my clinical trial at MSK will end this month. I was randomized to ONLY ADT( monthly firmogon) for one year. My feeling is my MO will stop the ADT and watch( that is what the nurse told me). I am not sure what to do if the MO advices with this. I had LN Mets in the abdomen and pelvic area based on the psma scan but not on standard imaging. I will not be able to reference the STAMPEDE trial because they used standard imaging. Should I drop of the clinical trial and ask for another year of ADT? I am tolerating the ADT ok. Thanks.

Tall_Allen profile image
Tall_Allen in reply toStayingOptimistic

In the new STAMPEDE M0 data, only 3% were recurrent and they were only checked for enlarged LNs on CT, as you say. In the Touijer study (below) which MSK participated in, the men with enlarged LNs were given long-term ADT.

prostatecancer.news/2017/12...

There have been no studies yet with detection of pelvic LNs by PSMA-only, so you and your doctor will have to discuss and decide together.

StayingOptimistic profile image
StayingOptimistic in reply toTall_Allen

Thank you, sir.

tango65 profile image
tango65

I would do at least 2 years of ADT plus Zytiga, this is a link to the data:

urotoday.com/conference-hig...

jbskiatook profile image
jbskiatook

I'm 79 and I was on intermittent lupron for 10 years and I had one Eligard shot and all I can say is you should just thank God that you're on Eligard and not lupron as I found Eligard was so much easier a shot to tolerate. On your duration I believe Yall Allen probably hit the Bulls eye but you need to follow what your doctor tells you with you doing research of your own.

Immd3414 profile image
Immd3414

With what you indicated, sounds like you are great shape....your Cancer is non-traceable....why are you having any more treatments? Is there something you didn't mention. Current PSA numbers are perfect...was there any involvement in lymph vascular? .was your Vas Deferens neg for carcinoma and tertiary pattern neg?

lhall2 profile image
lhall2 in reply toImmd3414

With my post prostatectomy grading of pT3bN1M0 with 1 of 10 removed lymph nodes positive, Gleason score of 7(4+3) and semenial vascular involvement, additional treatment (whole pelvic radiation & ADT eligard) was conducted. But like you said my subsequent PSA looks great. I have elected for another 6 mos Eligard injection. The question what is the requirement for AS. Continued ultra sensitive PSA in my current range may suggest going to AS in6 mos

Fairway profile image
Fairway

Sorry, no useful experience this situation. Wishing you best outcomes!

lhall2 profile image
lhall2 in reply toFairway

👍

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