Timing of Radiation treatment after starting ADT

[Scout4answers]

From the few studies I have seen the sweet spot ( for maximum shrinkage of the prostate) seems to be 12 to 24 weeks after starting on ADT ( I am on Lupron and Zytiga).

I want to hit the cancer with radiation when it is at it's weakest. Is there and reason to wait longer or conversely any reason to wait at all?

My prostate is 5x normal , about 150 grams est. and pushing up against the bottom of my bladder.

[cesces]

My Docs didn't seem to think it was all that important.

The sooner with either the better.

I wouldn't delay anything for the purpose of doing imaginary optimization.

[Tall_Allen]

The best time for weakening the cancer is two months after starting ADT. You can check that T is minimized before beginning. A recent meta-ananalysis showed there is no oncological advantage in longer neoadjuvant ADT.

However, it may reduce toxicity to shrink your prostate for a longer time, say 6 months before planning RT.

[Scout4answers in reply to Tall_Allen]

Thanks Allen

My PSA at 2 months on Lupron is 1.34 down from 21 and T is @<7, I started Zytiga the day after this reading, which was taken a week ago.

A recent meta-ananalysis showed there is no oncological advantage in longer neoadjuvant ADT.

They are proposing 24 months on both drugs are you saying that is no longer the gold standard ?

[Tall_Allen in reply to Scout4answers]

Sorry for the confusing jargon, "Neoadjuvant" means before the start of radiation, which is what you were asking about.

[Scout4answers in reply to Tall_Allen]

Thanks for the clarification, now I understand.

[Hidden]

Like TA said I did adt two months prior to imrt .

[treedown]

My Dr said 2 months and I started at 3. My RO said it would not be a problem for me to wait much longer to decide but I had already decided when I scheduled the first appt. I also liked the idea of doing it during the winter months and ending in spring.

[Hidden]

I wouldn’t wait long . They say 24 months of adt .

[ctflatlander]

My radiation oncologist wanted to wait one year to insure there wasn't further advancement of the mets. My prostate was 50% of its original size.(size before ADT). That was 3 yrs ago.