Optimal ADT length of time along with radiation for a recurrence 5 years post surgery-research or studies please.

[wilcoxsaw]

I know there are folks on here that can put their fingers on this quicker than I. There was a gentleman in the prostate cancer support group that I facilitate last evening with a recurrence of Gleason 4 + 5 , five years post-surgery. Could you please provide me with research studies or data indicating the optimal time for ADT when treating recurrent prostate cancer in this situation. He is also on zytiga along with the adt and undergoing 33 radiation treatments. I do not have any other specifics of his case so I cannot tell you what imaging he has had but I believe they are treating the area of the prostate/ pelvic areas.

Thank you

[Hidden]

Mine is pretty much the same, but 3+4.

4 year recurrence, my MO says lifetime ADT.

[wilcoxsaw in reply to Hidden]

Terminal, thanks for the info but I am looking for either studies or data to pass along that would indicate 6 months, 12 months, 18 months, 24 months, Etc of ADT in conjunction with radiation for a recurrence. If you can put your finger on that information and could kindly share those studies that would be great!

[Hidden in reply to wilcoxsaw]

one factor, where is the recurrence. Has it spread. How far?

Mines only a lymph node.

No 6 months 12 month. …forever

[Tall_Allen]

This may help:

prostatecancer.news/2023/02...

[wilcoxsaw in reply to Tall_Allen]

Thanks!

[Scout4answers in reply to Tall_Allen]

To your knowledge is anyone turning AI on these data bases to help come up with a statistical answer to the question of optimal length of ADT under the various situations?

[Tall_Allen in reply to Scout4answers]

I'm sure people who don't understand how to interpret research would think that AI is useful for drawing info from databases. People who understand do meta-analyses, and have been doing so for many years.

[Scout4answers in reply to Tall_Allen]

sounds like I am one of those that don't understand

Also as I recall you have a disdain for meta-analyses?

[Tall_Allen in reply to Scout4answers]

"GIGO" - Garbage In Garbage Out. AI doesn't fix garbage. I don't know why you think I have disdain for meta-analysis - I never said such a thing. MARCAP is a good example of how to do meta-analysis right.

[Scout4answers in reply to Tall_Allen]

I stand corrected

[Geo99 in reply to Tall_Allen]

Hi Tall,

I looked thru info on the link you provided to wilcoxsaw and still have questions if you can help; I had EBRT 9 years ago and most info seems to relate to removal. For 9 years I was clear , I have a PSA that ranged from .4 - .5 for those years. Over 9 months PSA went to .6, .71, and .9 when I started testing. I had a psma showing a single, positive pelvic node (1 above the Ureter). I am 1/2 way thru 28 days of radiation along with Abi. and Orgovyx (STAMPEDE model). I am in great shape, no fat, excercise regularly etc. I do have a condition call H.H.T. aka Osler Weber Rendu (nose bleeds, anemia, danger of AVMs). I am very concerned about overall degradation of my health if I do the recommended full 2 year course of the meds. I can not find good stats. on doing this for 6 months vs. 1 year vs. 2 years. Everything I find always seems to study Prostatectomy with psa's of course much lower than mine. I don't know if STAMPEDE has been around long enough to study the real impact with varied time intervals people may stay on it..? Thanks for your insights.

ps. I have a genetics study in progress since I am now the 3rd generation w/PCa.

[Tall_Allen in reply to Geo99]

Is your question - Can I expect worse response fronse from less adjuvant hormone therapy? The answer is, of course - yes. It's a trade-off that you have to decide upon.

[Geo99 in reply to Tall_Allen]

Thank you. I thought perhaps there were statistical analyzes done on survival rates with the different timelines on ADT. I was hoping that in my case, with a single node issue 9 years after erbt, that it's less aggressive than many who have multiple metastases and are on the same stampede model that I am on. My original diagnosis was with a Gleason score of 3 + 3 and my PSA was 1.6 at that time. I could be completely wrong, but it seems like a "one size fits all " approach..?

[Tall_Allen in reply to Geo99]

prostatecancer.news/2023/02...

[London441]

You can get all the data you can find and should, but I believe the man’s overall health is a factor that should be strongly considered in this. ADT is hard on the body and mind, and much harder on it for those with other health issues, co morbidities etc.

The survival benefit of long term ADT (12 months or longer) should be weighed against biological age. High blood pressure, diabetes, heart disease, obesity , etc. are all greatly exacerbated by ADT. Does he know his numbers? ‘The doctor says I’m doing fine’ means nothing. Lipid panel, BP, resting heart rate, diabetes markers, testosterone, Dexa scan, everything. What are his exercise habits?

Lifespan substantially exceeding healthspan is not pretty.

[RMontana]

LTADT (long term) plus LDSRT (low dose radiation) are the best combo for high risk PCa patient s.

healthunlocked.com/active-s...

The amount of GS pattern 5 he has is also predictive for OS (overall survival)!

healthunlocked.com/active-s...

Last, make sure he understands the impacts on his body from ADT. Not highlighted in many studies are impacts to sexual function. LTADT will end any that he may now have. If he starts ADT he must plan for this. There are things he can do to be proactive.

healthunlocked.com/active-s...

Let us Know what happens. He needs PSMA PET scanning before and after his treatment in case he has not obtained it. Rick

[wilcoxsaw in reply to RMontana]

Thank you Rick!