I am 84 and diagnosed with PCa in 2014. I had a multi-specialty work up Sibley Hospital in Washington DC (Johns Hopkins staffed clinic). No mets found. I was given 1 option, External beam; 70 Gray treatment went smoothly with no SE. I was given one injection of Lupron prior to the radiation. PSA went down of course. Following treatment PSA returned and really never settled down with a nadir but continued to rise. Doubling times about 12 months. The Oncologist proposed 2 options: 1. do nothing and haver a bone scan yearly. Wait for mets before treating. This would avoid SE of ADT and he asserted that survival would be the same. 2. Treat the PSA, . The watchful waiting went on for several years with doubling times of 8-10 months. After the isolation of COVID we moved to be closer to family (Utah). The new oncologist suggested Regulix oral ADT intermittently with 6+ month holidays. PSA was 130 and went down to less than .4. When stopped for the treatment holiday it rose to 18 in about 4 weeks so I was told that ADT would now be continuous. The new course was ADT until PSA started rising again. I asked about the yearly bone scan and was told it was not needed. As expected all the SE of ADT have developed.
When initially diagnosed I was referred to a couples support group. I was getting radiation and had no side effects. The group spent a lot of time talking about ED, etc.so I stopped going. Now after a year of ADT and in Utah I believe that support groups are necessary. I had a visit with a Nurse Practitioner for urologic symptoms and I mentioned the frustration of adjusting to life without any sexual activity. This NP then initiated a discussion which was amazing. Lots of information and useful things to try. Never once did she refer to age. This was so helpful that it was obviously time to find couples in similar situations to talk to. I raised the issue at the University of Utah Oncology Clinic and was told that support groups were not needed. I even offered to try and start a group and was told they would not support such an effort. This has me wondering if their approach to ADT with no diagnostic testing like bone scans is sound. It seems that I am a PSA number and nothing more.
Sorry for being long winded but I think this issue is important for others, not just me so I seek the wisdom of this forum. Thanks in advance.