ADT Vacation Ending - What are your Triggers

[swwags]

Hey guys. For those of you who take ADT vacations, what are your triggers for resuming ADT?

PSA => ?

Testosterone =>?

Others?

Also, do you proceed with a scan once you come back from vacation or focus on the numbers 1st?

I appreciate your feedback. My goal here is of course to learn from your experiences but also to consolidate some general information. The search functionality will lead me to 15 or so threads to read through and compile. The more posts to this thread, the less searching.

Also, I fully understand we are all different, on different drugs etc but still think the responses will help all of us.

[GP24]

What is the recommendation of your doctor? In this study they began with ADT again at a PSA value of 10 ng/ml. nejm.org/doi/full/10.1056/n...

[swwags in reply to GP24]

Thanks. I didn't ask my doctors yet. I would like personal input from those on here who have taken breaks, I hope we get enough answers here so I don't have to hunt and peck when/if the time comes. This site has a lot of great information but there are few threads that compile information into a concise format.

[DarkEnergy]

Before break, PSA < 0.02, Then eventually my PSA started doubling:

11/6/20 <0.02 - Last Lupron injection

2/18/21 <0.02

5/19/21 0.09

6/25/21 0.18

7/22/21 0.27

8/19/21 0.55

9/16/21 1.10

10/22/21 2.17 - Lupron injection

12/3/21 0.20

1/21/22 0.13

1/26/22 - IMRT to Prostate+Pelvis

[ARIES29]

My PSA is 0.3 & I am off treatment for 2 months now. In 3 months I will have PSA test again & looking for PSA doubling or just staying low. The PSA level should be below 4 I am told.

[Schwah]

Since I began with a focal cryo-procedure, I was left with 60% of a rather large healthy prostate. Therefore my PSA normally would go to about three or four when I go off my meds, even without any cancer. Therefore I get PSMA scans every six months. When they see a spot, I radiate with SBRT and go back on my meds.

Schwah

[lokibear0803]

We monitor PSADT and absolute PSA level. If I have a lower PSADT, this could mean higher absolute PSA level before restarting…but I’ve never had a low PSADT. My DT has always been b/w 3-5 months, so we resume ADT/zytiga at PSA typically about 7-8.

But I think this rule of thumb would vary (considerably) depending on various other risk factors, e.g. gleason, staging, volume, previous treatments, ECOG, etc.