Clarification on the timing of ADT

[Mischa1111111]

Just started my IMRT treatment. Beginning with the 2nd RT,I started taking Bicalatumida 50 mg for 10 days and then i will get the injection of Decapeptyl 22.5 mg and will continue for taking evry 6 months for a total of 18 months. I am what would be considered in the states intermediate unfavorablewith clean bone scans and TAC . And even if it is a moot point I would like the opinions of the timing of these drugs(before,during, after) to get the most of my treatment of 25 sessions. I was told by my last urologist that the tumour is considered localised. Also has anyone stopped there ADT treatment in less time with the desired results?

[Desanthony]

I had ADT for 9 months and RT for a month my stats were PSA 13 Gleason score 7(3+4) and T2 N0M0 though T3 disease could not be ruled out because the tumour could be seen to be pushing out of the back of the prostate on MRI scan so microscopic local spread could not be ruled out. Still here with undetectable PSA 6 years later - so as likely cured as could be hoped.

Some specialists keep you on ADT for anything up to 3 years here in the UK it seems to depend on their own practices or those of the hospital. Either way they aim to either cure - which looks to be the outcome for me or treat most effectively.

The reason my rad.onc decided on only 9 months of ADT was that if there had been spread or recurrence he wanted to keep that tool in the box to use later and also said he wanted to spare me too many side effects from ADT as I was otherwise fit and healthy especially for some one of my advanced age and the longer he could keep me that way the better without problems brought on from side effects of ADT. Another specialist or another hospital and I would have been on ADT for 2 years.

[Mischa1111111 in reply to Desanthony]

Thats good to hear . So your ADT treatment started before RT and then continued on ?

[Desanthony in reply to Mischa1111111]

Yes, usually you start your ADT before RT. The ADT lowers the PSA and also weakens the cancer cells so that when you have your RT it has a greater effect. At least 3 months of ADT before RT usually I had 6 months prior to RT and had my last 3 month long imnjection about 2 weeks before the RT started. My Rad. Onc. told me that the effects of the RT would still be in my body getting gradually less for at least the amount of time I had been on the injections so 9 months. It would also enable him to get a more realistic PSA and testosterone reading at the 4th check up after cessation of RT.

[Nusch]

I started ADT Lupron one month before RT and continue for 15 - 18 months.

[Mischa1111111]

Ok . Seems I missed the boat on that one . But the treatment goes on. Who knows? Love this group and thanks for getting back.

[Tall_Allen]

If you can get a Decipher Genomic test, that might lead you to take more or less ADT. In the following trial, they are sorting patients into those who need more from those who need less:

clinicaltrials.gov/ct2/show...

[Mischa1111111]

Thanks . It is something i have heard about . I didn't know about the clinical study and haven't heard about it in Spain . Will ask

[MateoBeach]

Since you are asking about the most advantageous way to start ADT and timing with RT, then take a look at this article that leads to a different approach. Not taking the bicalutamide, but starting the ADT at the same time as starting the RT. Androgen “flare” to make the cancer more vulnerable at the start of ADT. But no anti androgen.Read this article and discuss with your doctor. Worth considering.

ncbi.nlm.nih.gov/pmc/articl...

[Mischa1111111]

thanks for finding that . If I had known sooner .

[Mischa1111111]

Thanks everyone . I am really glad I posted Thanks for your reaponses and experiences .