Bone scan results in

[Wahoo_]

I just met with my MO's nurse practitioner for my bi-monthly appointment. She gave me the results of my bone scan and CT from last Monday. The results are in....all clear!!! Now, should I consider a vacation from my ADT or continue on. I was so stunned I forgot to ask. I meet with my MO in May. I have been on monthly Firmagon injections and taking 2 80mg tabs of Xtandi every night for a year, now. Thanks!

[Tall_Allen]

Why do you want a vacation? Are the side effects of hormone therapy intolerable?

[Wahoo_ in reply to Tall_Allen]

no..........not at all. I was thinking about becoming castrate resistant. I'm kind of dumb in my knowledge of this disease.

[Tall_Allen in reply to Wahoo_]

They found that intermittent ADT does not delay the time to castration resistance. The genomic changes continue to evolve to castration resistance even without ADT, No ADT gives the cancer cells more opportunity to survive, mutate genetically, and spread. The only reason to take a vacation is if it's intolerable, and you need a break.

[Wahoo_ in reply to Tall_Allen]

Thanks.....the old adage, if ain't broke don't fix it applies here, i suppose

[Schwah in reply to Tall_Allen]

You say “No ADT gives the cancer cells more opportunity to survive, mutate genetically, and spread.” I have never seen any study that shows that to be true. In fact most studies I’ve seen indicate no discernible difference in overall Survival between CADT and IADT. Both Dr. Scholz and my second opinions at UCLA have told me the studies show no real survival difference. Are there any new studies that now indicate intermittent ADT reduces survival?

Schwah

[Tall_Allen in reply to Schwah]

Why do you suppose ADT is given? It is not new -- they have given ADT since the 1940s. It is the most basic therapy for prostate cancer. I'm surprised that you don't know this.

As for iADT vs cADT in metastatic men. The definitive study was Hussain's. They tried to prove iADT was not inferior to cADT. To be called "not inferior" the hazard ratio for death of men using iADT had to be 20% inferior, but it was only 10% inferior. But the 90% confidence interval was 0.99-1.23, meaning that 1% might do better with i ADT, but 23% might do worse.So for some, the inferiority goal of 20% was exceeded, But up to 1% did better with iADT.

Median survival was 5.8 years for cADT and 5.1 yrs for iADT.

nejm.org/doi/full/10.1056/N...

[Hidden]

Don't stop now.

[Concerned-wife]

I think, with bone Mets, they would want you on treatment for two years first , so you have time to study and consult with your oncologist or obtain a second opinion. TA sums the major study up accurately, but my husband’s consulting oncologist has suggested eventual intermittent for him, who was de novo metastatic to the bone, doing very well on Adt, Abi, and radiation to prostate and a pelvic met. No decision made here yet. 2 years of treatment will be in August so he is studying ( and appreciative of doing so well).

[SteveTheJ]

Count your lucky stars but don't stop anything unless advised to do so.

[Hailwood]

I agree with TA, in that if you aren't struggling with side effects, then keep going. I will be having my third bone scan in April and while my joints are a little stiff and a little "jelly belly" is there and some general muscle wasting, my PSA remains at 0.01 and T is low and so if this bone scan is negative, I'll just plough along and can still work full time, riding my motorcycles. Stay the course my friend.

[j-o-h-n]

Wahoo? You!!! Keep beating that war drum....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/08/2022 10:09 PM EST

[Wahoo_]

Thank you all for the encouraging responses. I don’t get on here often but I want everyone in this forum to know you are in my prayers!! WE HAVE TO STAY STRONG!!!