4th opinion Central Fl

[Dsmejkal88]

Hi everyone! My dad has been on Lupron and Zytiga since March of 22 and has been undetectable since April 22. His RO and MO at. AdventHealth want to take him off Zytiga and one more shot of Lupron to him a break then wait and see. The MO at Moffitt says no, at least two years. He wants to be off it, he’s burnt out and wants some semblance of his life before cancer. We ( brother and mother) are afraid of what could happen and want him to stay on it, since it’s working. But of course this is his journey and his body. He wants a 4th opinion before deciding. Any insight would be great. Background he was diagnosed in March of 21 with pca, scans were clear and had the radical prostatectomy in august ( psa was a 3 in 17, 9 in January of 21 and 16 in June 21). He was told it was aggressive but he was “cured” and to follow up in 6 months. His pcp didn’t like that idea and ordered blood work December which revealed a .08, three weeks later .4 and then it was a 1.2 when he was sent to the RO and MO in March 22. He had salvage radiation with Mets in the bed and one by his S1 in May and finished early July. He’s been undetectable since April . Any suggestions on where to get a 4th opinion. I really don’t think he should stop the treatment. Thank you all for reading through this!

[Alturia]

I believe rhe NCCN guidelines for someone that has persistent PSA after a prostatectomy is 24 months of ADT (lupron) plus aberaterone and prednisone. Take a look at NCCN.ORG and then look up prostate cancer guidelines.

I am in exactly the same situation as your father. Had RP in January of 2022. Had persistent PSA. Went on lupron, aberaterone and prednisone in May 2022. Had radiation to prostate bed and pelvic lymph nodes in Nov/Dec 2022. I will be on the drugs for 24 months.

[Hidden]

if my husband had that option, believe me, he would grab it. These are the worst decisions, I understand! I miss life without fear❤️

[Hidden in reply to Hidden]

It is very difficult!! Age and other health issues sure complicate things.

[Tall_Allen]

The bone met at S1 means that he is not cured and will need hormone therapy for the rest of his life. The question is - can he have a vacation without harming him? That will depend on the individual, but it is a risk. The other question is whether his testosterone recovers enough during the vacation before the cancer spreads again so that he gets some relief. It is impossible to know these things in advance, and no amount of second opinions are going to give you an answer. It's a judgment call.

[Hidden in reply to Tall_Allen]

Perfect advice Allen.

[London441]

I hope the urologic surgeon who said his prostatectomy was curative and to come back in 6 months is no longer involved in his care. That was painful to read and I’m sorry. A break from the drugs may or may not provide any relief but as TA says it is a risk.

It also depends on what he means by ‘burnt out’. I assume it’s the fatigue. How much does he exercise and what kind?

[Hidden in reply to London441]

Six years ago my husband had 44 radiation treatments for stage 3 PC. The radiologist oncologist pronounced him cancer free after completion. No scans, no proof. Husbands urologist had previously told us in the beginning the cancer was most likely already in bones since his PSA was 105 at diagnosis. Cancer cells were too just small to show on scans yet. Urologist was right. I thought at the time the radiologist was very wrong to say my husband was cured. PC is a constant, life long battle. Especially if not caught early.

[VCinTx]

Read this article. I stopped Lupron after 18 months as I was PSA undetectable.

pcf.org/news/18-month-adt-o...

[Hidden in reply to VCinTx]

Undetectable in no way means cured