I am now sixteen months no ADT. As of two weeks ago PSA is < 0.04 T is 10.
Radiologist I still have a prostate) wants to radiate, one oncologist wants to do Chemo and wants to do nothing or high T treatment. Axumin scan three months ago show some more shrinkage from PSMA scan of eighteen months ago. Last ONCO thinks cancer is dying and is unable to replicate itself. Did four trips to Heidelberg AC-225 and LU-177 last trip July 2020. Question is when I should go back on ADT and Iam thinking of Orgovyx ? Thank you
This is my 22nd year in the battle.
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lewicki
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In this trial the started ADT again when the PSA value got higher than 10 ng/ml. At 0.04 I would not do anything - except SBRT to the prostate perhaps.
I agree from the info you posted here why would these doctors now be recommending radiation and chemo? Sounds like you are doing well without needing either treatment.
You are still on ADT since your testosterone is 10, at castrate levels.
Since the cancer failed ADT and zytiga treatment , I believe the cancer is metastatic castration resistant.
I do not understand why they want to irradiate the primary tumor with metastatic disease in what I believe is castration resistant cancer.
I will not do anything at this time. Check your PSA and Testosterone frequently every 2 months, just not to get a surprise the testis will wake up and your testosterone go way up.
I am in a similar situation with the testosterone and my MO measures the T every month.
Your testis are not responding to the suspension of lupron or similar and the testosterone remains at castrate levels. If you were really out of ADTyour testosterone should be above 50. I have the same problem and my doctor calls it, free ADT.
To my knowledge the treatment of the prostate does not prolong life if one has or had more than 3-4 distant metastases. The treatment of the prostate could be done to try to prevent local complications down the road.
The ranges are very different. “Normal” T in ng/dL is about 300-1000. In nmol/L it’s about 10-30. So 10 would be “normal” in nmol/L but very low in ng/dL. USA uses ng/dL but UK, Australia use nmol/L so sometimes it can be unclear what scale is being used!
GReat. But my only question is should you get another PSMA/PET or a metabolic PET other than Axumin since it seems to be evolving into a less reliable scan. No easy answer unfortunately from my reading.
If the T is 10 in ng/dL then you are still castrate and do not need any other ADT now. And your undetectable PSA persisting so well after Lu/Ac is just terrific! Chemo now would fit Extinction Dynamics theory but would be considered radical, not SOC. I would have a long discussion with that MO to understand his thinking.
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A new chapter
Lupron ( ADT ) vacation
Thinking of taking an ADT vacation 
Vacation is over - Cancer spread - two spots in the bone and new lymph nodes. Suggestions ?
