Hi all,I am wondering what are your views on intermittent ADT?
PSMA Pet scan has revealed one met in my ribs...it was treated with SBRT.
I was given a 3 month Lupron shot which reduces my PSA to 0.24 ug/l.
I'm considering going on IADT....6 months of ADT followed by 6 months break and repeat.
Anyone tried such a treatment...what are the results?
Thanks for any advice.
I would have my prostate either removed or radiated.
I had already undergone 20 sessions of RT to my prostate in August last year.
Sorry, I missed that. If I were you I’d stay on ADT plus abiraterone for awhile longer. I’m going on a two year medication holiday (abiraterone + Lupron) and am still undetectable. Your PSA is coming from somewhere. Did your PSMA show anything around your prostate?
What is your current PSA ?
0.04
Excellent .. may you remain there for many years!!
Do you have mHSPC? Or?
How long were you on lupron, and abira? Were you also on prednisone?
Thank-you for your kind thoughts. I have mHSPCa. Diagnosed 7/2/2018. Lupron 1st 8 months then Lupron + abiraterone w/prednisone for about a year switching from prednisone to dexamethasone , then taking about a 6 month vacation from cancer meds, then back on lupron, abiraterone w/dex until April 2022 when I stopped the Lupron and then stopped the abiraterone/dex in July 2022. On vacay ever since. All my treatments under MO supervision. One thing I did early on in 2018 was go through the Rick Simpson cannabis protocol. I hope that may have destroyed CTCs. So, like a lot of folks here I’m a clinical trial of one. Everyone’s PCa seems unique.
Thank you.
Yes I agree. Each person is a trial of one.
My dad was first diagnosed at 70, 15 years ago. It was localized. He had an RP the radiation. He was fine until OCT 2021.(83) in great shape otherwise.
Went to emergency. Surgery on tumour in his thoracic the next morning. Told he had 2 months. 5.5 weeks in hospital. Big recovery. Told he would never walk again.
Walked within 2.5 months. Sent 4 homecare nurses home, the bed lift, the wheelchair. After 5 months. All doctors call him remarkable, a miracle… his GP says “he has surprised us all”
He took 2 shots firmagon. Then switched to abira and 5 mgs Pred and ELIGARD every 6 months. His PSA was at 5000 in Oct 2021 has steadily declined with last in august a few weeks ago at 0.046. Testosterone is very low. Heart, liver, kidney all great.
As well as conventional treatment, I am cooking all food …for her and my 98 yr old mom.. 98% whole foods.. 40 % raw. High cruciferous and home grown veggies collards, turnip greens, Swiss chard etc, id say a Mediterranean ketoish low carb diet with lots of salmon and sardines, nuts, beans, some fruits, dark chocolate, etc Also supplements ie…high dose vitamin D, Curcumin, garlic, C60, ionic calcium, fúlvic /humid water, and also a type of RSO.. THC and CBD oils over past 10 months.
As well as gardening, movement, walking when he can, tremendous faith, community, lots of family visitors ,.
We believe all if this and more have helped my dads body to heal and to respond well to treatment. It seems to all be working for him.
He was having pain in his hip… which was x-rayed… they came back no tumour but def arthritis … so we are handling that…
I believe my dad will die of other causes and not PCA. 🙏
I had recurrence after RP and first RT. Did another RT to prostate bed and whole pelvic floor. Since then I’m on Lupron and will stay for 24 months. PSA is undetectable since then and all PET/CT (PSMA and F18) are clean. Would not risk iADT as long as nadir isn’t undetectable.
Here's some info:
prostatecancer.news/2023/04...
Hi TA long time. I am confused when I look at the clinical trials that state that combined ADT plus XTANDI had reductions or improvements however you want to look at it compared to ADT alone. Those huge percentages are a measure of events to base 100% or its just that a 1% became 1.5% because I tend to see that clinical trials will show those improvements without proper reference and it makes me wonder if they are simply pushing their product. My question is not very well phrased but I hope you will get the meaning
Un abrazo amigo
Ricardo
In the ENZAMET trial, 5-year survival was 57% for Xtandi+Casodex and 67% for Xtandi+ADT.
Thank you
Thanks TA for the info.
Great article , Tall One .
"I'm considering going on IADT....6 months of ADT followed by 6 months break and repeat."
Don't understand this strategy, for instance, maybe the testosterone levels won't recover in 6 months. If it doesn't, will you proceed with testosterone replacement therapy?
I went on ADT vacation, but my testosterone castration levels has not recovered, currently reluctant to recover.
Thank you DarkEnergy for your response. Has your PSA risen during your ADT vacation?
I have decided to continue with the ADT and monitoring my PSA regularly. My plan is if my PSA becomes undetectable (<0.1) for say 6 months, I may then consider taking a break from ADT, and going back on it if the PSA starts rising.I saw the oncologist today and had my second 3 month Lupron jab. My next blood test is in 1 month's time.
"Thank you DarkEnergy for your response. Has your PSA risen during your ADT vacation?"
No, PSA has not risen, but my testosterone has not risen as well. This can happen, I'm just reluctant to raise my testosterone by injections. Sounds like pouring gasoline on a fire...
If testosterone does not recover, are you safe with that since it's T that feeds the cancer?
Yes, it was safe, but wanted to see if my testosterone would rise naturally - it did not. I'm just reluctant on getting testosterone injections, seems risky, since my initial prostate cancer diagnosis registered at PSA 1000+!
Check out adaptive therapy approach. You are on the path.
I had Trelstar injection every 6 months for two years.
Been off about a year and a half. So far, so good. PSA to low to measure. I have the full gynecomastia boobs, belly, and butt though.
☹️
I've successfully been doing intermitten ADT for over 2 years. The protocol my MO and I came up with is once I'm undetectable for > 3 months, I go off ADT until my PSA goes over 2.0, then back on ADT....currently back on ADT but hoping my next labs show consistent undetectable PSA, which would make it > 3 months....last session I was able to stay off ADT for 5 months before going back on....my MO provided studies showing no significant risks as long as you immediately go back on after reaching that predetermined PSA level. Good luck and do your own research and consult with your MO.
Thank you Austinsurvivor for sharing your experience. I think the protocol you outlined above is interesting and I might just follow that. Is there a minimum period you need to be on ADT before following such a protocol?
I was on ADT for 1 full year before my MO and I decided we could try this....hope this helps.
Thank you. Yes, the info you provided helps me to formulate my own strategy in managing ADT. Do you test your PSA monthly?
For those with low baseline PSA <0.50 six months of adjuvant ADT with SBRT MAY BE sufficient. That is what I did. If testosterone does not recover with IADT then it is not truly an ADT vacation.
Adaptive regimens such as variations of BAT and cycling on and off Abiraterone according to PSA levels are showing great promise.
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