What study says Zytiga 2 yrs , ADT 3 yrs ?

[reconjj]

Im off to see my MO today and am getting close to the 2 yr. mark . All is good so far . I just need to know what was the study that suggests ADT for 3yrs and Zytiga + pred. for 2 yrs . I think tall Allen mentioned it . Thanks , SemperFi , JJ

[Magnus1964]

Why are you limiting your time on zytiga? If it's still working stay on it.

I have hearing a lot the brethren on this forum taking about time limits on prostate cancer drugs. If a drug is working, why stop! There is no reason to stop a drug if it's still working. Tell your doctor he's full of crap.

Magnus

[reconjj in reply to Magnus1964]

Thanks Magnus , my MO is at V.A. Even though she is a MO at Loyola University also , she follows the protocol of V.A. Originally she wanted me to go on vacation at 2 yrs . Im at 18 months now . So I have a little time .

[Magnus1964 in reply to reconjj]

I am getting the feeling that that time limits and ADT vacations are an attempt to prolong testosterone sensitivity. It's a crap shoot. You didn't sign up for this. Your looking for the best treatment for you.

[VCinTx in reply to Magnus1964]

QOL means a LOT to me.

[jmarsh in reply to Magnus1964]

I would assume that jj, like me is hoping that he is cured. The only way to know is to stop the ADT. I've had RP and radiation and now 14 mos into my ADT with Lupron, Abi and Pred. I don't like the side effects and would like to get off at 2 years. My RO and MO have indicated that I have about a 70-80% chance of being cured. Are they lying to me?

[Magnus1964 in reply to jmarsh]

There are those who catch prostate cancer early enough and a radical prostatectomy is successful.

Stopping ADT ís a crap shoot. If your PSA does begin to rise and aboraterone no longer works, you may have to go on another drug. Casodex or xtandi would then be a good choice.

[mrscruffy]

Been on Lupron/Zytiga for 7 years and 2 months. Still going strong

[Mascouche]

I think it was either CHART or Stampede. Tall Allen would know better.

[Tall_Allen]

This one:

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

[reconjj in reply to Tall_Allen]

Thanks Tall One

[Tall_Allen in reply to reconjj]

Did you get the problem resolved with your testosterone level?

[reconjj in reply to Tall_Allen]

Yes Allen , I retested with the U Of Chicago 1 week later and it was <7 same as the last 6 labs , 18 months in . I just saw my MO at V. A. and she said at 2 yrs I can continue with Eligard, abi , pred if I want or do the 1 more yr on Eligard and stop abi and pred if I want . She did mention as you have being that I had 1 small pelvic lymphnode radiated and the entire pelvic area radiated that the cancer could be gone . Ive got 6 month to see what Im gonna do . Kinda leaning about keep on the same route , Eligard , abi , pred . Dont know yet . Thank You for asking . SemperFi , JJ

[Tall_Allen in reply to reconjj]

Lab errors happen - always a good idea to retest when something is out of whack.

[Tigger2022 in reply to Tall_Allen]

Sorry to butt in, but this is also the paper I have been looking for.

My husband should follow this, yes? Gleason 4+4, high Decipher score, node positive with increasing PSA within a short time after surgery. He had radiation and has been on ADT (currently Orgovyx) for one year and Abi/pred since January. So he should continue the ADT for 3 full years? (His MO is ok with him stopping meds in 6 months, which is why I’m asking…)

[Tall_Allen in reply to Tigger2022]

That's a somewhat different situation in that none (or very few) of the men in that trial were recurrent after surgery. But node positive men should have at least 2 years of ADT. The following clinical trial is giving men both ADT and Erleada (apalutamide) for 2 years. It is probably even more important to intensify hormone therapy with the high Decipher score.

classic.clinicaltrials.gov/...

It may be difficult to get apalutamide, but it may be possible to intensify with abiraterone.

[Tigger2022 in reply to Tall_Allen]

Thanks very much for your explanation. I appreciate it!

[Lettuce231]

I personally think its incredible that you've been advised to take a vacation, I can't understand why. What are you expecting to gain from it ? Your treatment is doing what its supposed to do, why stop it ?

Recently there have been many people on here who want a "vacation ". You will let the beast back in, I've been having treatment for nearly 10 years, Lupron, Zytiga and prednisone have saved my life, why would I or anyone else turn there back on it and literally open the door to the beast.

Think carefully 🤔, I wish you well.

[Vangogh1961 in reply to Lettuce231]

Thanks for your reply. I keep reading about vacation to allow testosterone to return to ameliorate the effects. With daily exercise I've limited the effects and am glad to see someone who's been on the same treatment for years.

[Lettuce231 in reply to Vangogh1961]

Exercise, even gentle exercise is very important. You can build up your stamina, it doesn't have to happen all at once. Its a marathon, not a sprint.

Stay positive, all the best to you.

[London441]

I think there is too much opinion being served up as fact on this. Many very reputable MO’s are shortening ADT courses or allowing vacations to relieve patients of side effects, or merely to see what happens. With a preset plan to return to ADT if necessary.

The specific risk of this is real and should be known obviously. It has been detailed here.

Still, shorter courses of ADT/intermittent are not just driven by patients insisting on them. There is a growing movement in the medical community away from dogmatic use of ADT. It’s a controversial area even among experts.

I am not one. However, it seems clear there are a number of reasons why shorter courses or vacations could be particularly preferred. A man who is much older. One whose physical health is very poor. One who knows the risk and is more than willing to accept it. One who has had no evidence of disease for a very long time.

All I’m saying is there are many docs who are invested in this, and I don’t believe we are in a position to essentially declare them all incompetent.

[Mikes21]

Are your bones affected by the hormone treatment? Cause I have osteopenia that has worsened and I don’t want to get to osteoporosis

[AMIN25]

I think the vacations are suggested as continuing on hormone treatments can lead to cognitive declines.

[Atlpapa]

Is your current ADT + for a curative treatment?

[Pop1959]

Hi all, Gleason 10, coming up to my last zoladex injection which will complete 2 years ADT after 39 rad zaps. My specialist suggested stopping but stated G10 local in fit 63 year old, who knows!! G10 local is not something seen very often here. He agreed if its not broken don't fix it, happy for me to stay on it for as long as I want.

PSA 0.1 fit and healthy.

Cheers

Dale.

[robert570]

I was on Zytiga and prednisone for almost 4 years then it stopped working.

[Lunbo]

I was on Zytiga for 5 yrs. with few side effects but efficacy finally diminished and I switched to Erleada for 3 yrs., then on to Xtandi and then Nubeqa which were ineffective , went to Pluvicto with great results! Stay on the drug as long as effective!!