Need a vacation from adt

[northshoreguy]

Gleason 4+3, RP followed by BCR after five months. One tumor in my pelvic area. One month shot of Lupron followed by SBRT, 9 more months of lupron/Eligard then 12 months of Orgovyx. I have been undetectable since 30 days after my first Lupton shot. My MO recommended 24 months of adt, I would love to stop now (22 months) as I am mentally and physically exhausted (I work full-time). Do you think I would be shooting myself in the foot by stopping 2 months early?

[Tall_Allen]

There aren't any standard protocols for intermittent ADT. You may want to discuss in advance the trigger(s) you will use for ending the vacation: time, time with normal testosterone, PSA, PSADT, new metastases, or pain.

[northshoreguy in reply to Tall_Allen]

From reading some your other posts you mentioned that psa is not a reliable marker if you are metatastic. Did I interpret that wrong?

[Tall_Allen in reply to northshoreguy]

It is reliable for most recurrent men.

[northshoreguy in reply to Tall_Allen]

Thank you very much. I put your opinion up with my MO

[northshoreguy]

No,North shore is north of Boston. Right now I am still undetectable .I believe all ThE psa tests have come back <.02

[tango65]

Where was the one tumor in the pelvic area? If it was a lymph node the cancer is not metastatic and you could stop the ADT since it is going to take months for the testosterone to recover , at least 6 months or more.

[northshoreguy in reply to tango65]

Unfortunately it was in the pelvic bone not lymph node.Thank you

[reconjj in reply to tango65]

tango 65 , you say cancer in a lymph node is not metatastic ? I have oligometastic , 1 tumor in the lymph node and my V.A. MO calls it metatastic . ?

[tango65 in reply to reconjj]

I said if the lymph node is in the pelvis. In the pelvis only,, positive lymph nodes make the cancer N1M0. I f outside the pelvis a positive lymph node makes the cancer M1 or metastatic.

[Magnus1964]

If your current treatment is causing you distress, ask you doc about switching to another ADT treatment. But don't stop all ADT treatment.

[northshoreguy in reply to Magnus1964]

What other treatments would you recommend that wouldn't have the same side effects?

[Magnus1964 in reply to northshoreguy]

You could stop Orgovyx and switch to casodex. It is an older ADT drug with less side effects. I was on casodex while I was still working. If your doctor doesn't like casodex, mention zytiga.

[northshoreguy in reply to Magnus1964]

I was on zytiga but was taken off of it due to a heart attack. Also had worse side effects than orgovyx. I'll ask my MO about casodex.Thanks for the info.

[jazj]

One of the significant findings in trials with Orovyx was a statistically lower chance of cardiac related negative side effects.

In very generalized big picture terms, if the different roads all eventually end up at the same destination, how bumpy the road you choose to travel along the way is a significant consideration in addition to where and when you end up.

What does your Oncologist say would be the most likely long-term effect if you stopped your ADT early? Maybe their honest answer is "I really have no idea." If they can't definitively say it very likely will make a significant difference in the longer term, give yourself a break and enjoy a better quality of life.

[Horse12888]

If you're finding the SEs of LHRH drugs like Eligard intolerable, you may want to look into high-dose transdermal estradiol (tE2) as an alternative. It's not FDA approved, but it's used extensively, especially outside the U.S. where massive phase three studies have been performed successfully.

The presence of estrogen both brings down T to castrate levels and, it is believed, substitute in the brain for T so as to offer a SE profile that is FAR more tolerable in terms of fatigue, hot flashes, brain fog, emotional lability, aches, sexlessness, depression, etc.

If my PSA continues to rise, this is definitely the route I'm taking. I was on Eligard for 12 months (quit mid-way through a 24-month prescription) plus another 5 to recover my T, and I really wanted to die. That's not happening again.