Dubious ADT treatment

[Mustbecursed]

My father had RP late 2019, pT3a, Gleason 6, negative margins, positive node. 0.012 PSA 3 months after followed by 0.024, 0.04, 0.032, 0.04, 0.05, 0.06 and finally 0.052 at late 2021, two years after RP. Frankly the doctor he was going to seems like quite a clueless old guy who seemingly changes his mind for no reason whatsoever, recommends to start ADT at 0.05, then doesn't at 0.06, then does again at 0.052, prescribes flutamide and at next check up is surprised about his own decision, but since it lowers PSA, keep doing it.

Anyway, he was taking flutamide for almost exactly a year with 0.01 or a bit lower PSA and finally changed his doctor who said there's no reason to continue taking ADT and it shouldn't be done until at least 0.2 and the old guy decided to just treat PSA itself for no reason. Now the PSA has risen back to 0.023 in about 40 days which was expected, but still seems quite fast (is it?)

Also potentially bad thing is the fact that he wasn't following the drug regiment correctly and turns out it's likely the main reason why he wasn't feeling that many side effects, flutamide was supposed to be one pill 3 times a day but he usually had 2 or rarely a single pill. Overall I'm somewhat worried this whole ordeal with starting ADT so early and not even following it correctly did more harm than good. Is it an expected result after stopping this treatment?

[Justfor_]

I am doing something very similar taking a varying dose of Bicalutamide with a PSA target of 0.05 +/- 0.01. I maintain a thread here documenting it frequently.

[Tall_Allen]

There is no reason to start ADT at his PSA. It causes harm. Flutamide will create antiandrogen resistance.

[Mustbecursed in reply to Tall_Allen]

Pretty much what the new doctor said, I just hope taking it for a year didn't do too much harm. Would you say him not taking full dosage quite often made it faster or slower in terms of creating resistance? Is it akin to not completing full course of antibiotics?

[SteveTheJ]

Those PSA numbers are very low. You should go to another doc.

[cancerfox]

I would be doing a victory dance with a PSA of .023. Seems like you wouldn't want to subject someone to the side effects of ADT, or risk future immunity to it, for such a low PSA. 🦊

[KocoPr]

It’s been a year. How is your father doing ?

Is he still off ADT?