Thinking of taking an ADT vacation

[John347]

Hi, just got my latest PSA result yesterday...it was 0.07 ug/l down from 0.14 ug/l one month ago. I'm almost at the 6 month mark of my ADT journey. Six months ago, my PSA was 14.9 ug/l. I'm thinking of taking a break from the ADT because of the side effects. Is it too risky? Would the PSA start rising once my testosterone level rises naturally after I stop the Lupron jab?

What does the current low PSA level means? ...that the cancer cells are asleep/dormant?

And if the PSA starts rising, does it mean the cancer cells are being aroused from their 'sleep' and tumours will start growing?

If I do take a break from the ADT, what is the threshold level of PSA where I need to take action...like resuming the ADT?

What is the chance that the PSA will remain <0.1 for next few years after stopping ADT?

My oncologist has pretty much left the decision to me whether to take a break or to continue.

Thank you for any advice.

[Big_Mcc]

Your life. Your choice. Your risk. Do you feel lucky?

[Kaliber in reply to Big_Mcc]

Lol ….no kidding …

[John347 in reply to Big_Mcc]

You're sounding like Dirty Harry...Lol

[JohnInTheMiddle]

We had a discussion about this (ADT vacations) recently here on the Forum. We all need to realize that we are fighting cancer, not PSA. PSA is only a proxy for cancer; and it's pretty good but not perfect. And if you're unlucky eventually it's not a proxy for cancer anymore at all.

From your bio it's not clear that you have metastases. Anyway think of cancer as like rust. Don't forget rust never sleeps (or maybe more accurately in the context of prostate cancer, it will only sleep if you're putting pressure on it, i.e. when you're taking your ADT etc). Also don't forget that when you're dead you don't have any quality of life.

From my perspective one has to keep fighting all the time. And taking a holiday means you haven't done enough reading yet. Oh, and don't forget to exercise. A lot!

[Kaliber in reply to JohnInTheMiddle]

Yes …. Well said.

❤️❤️❤️

[John347 in reply to JohnInTheMiddle]

Thank you John for your response and advice.

[Adlon57 in reply to JohnInTheMiddle]

Thanks JohnInTheMiddle that answers a lot of questions that my so called PC support team have not told me, diagnosed with PC in June 2022, I was given 20 sessions of radiation, and hormone injections, last PSA 0.06🤔 but no reply on how good or bad, try to get in contact, they heard my hormone injections caused life changing reactions with my fragile rib cage structure/osteoporosis🙄so am treated with kid gloves presently, some specialists from my other colourful medical conditions 🙄 tend like me to wonder do I have cancer at all🙃[a very good chance it might be a reaction to my Schwannomatosis NF3, something like AZ vaccine reaction in 2021😤] but I have a PSA on Friday, and FINALLY a telephone appointment about progress next week🤞 I admit my medical history is 'unusual' thus I usually get a "second look" via any medical authorities looking at my medical cv!😵 I have learnt over the past year that cancer treatment is not black and white, rather like my epilepsy treatment over the last 50 years is definitely not black and white, a LOT of patience is needed via both conditions, Cancer and Epilepsy! I have taken up using my exercise bike, gingerly, I fell off it in 2017 onto my chest and shattered my rib cage, rubbing the dust off it, in the last 6 months have definitely noticed the benefits, no good just sitting around👍 p.s. have not had a holiday in nine years😒

[EBBEFLUT]

Hi there, I think it will be very risky, depending upon waht your Gleason-score is.

I have a Gleason 9, my uro warns to do this since I was recommended by another uro to take orgovyx instead of ADT-injections, then taking a break from orgovyx until PSA-level was up to 7 again, then restart taking orgovyx. Personally I voted against this kind of treatment, continue with ADT (Lupron every 90 days), my PSA-level is down to undetectable, why take more risks ?

EbbeFlut Germany

[John347 in reply to EBBEFLUT]

Thank you EbbeFlut for your reply. My Gleason score was 7 (3+4) at diagnosis. I will probably continue with ADT for 18 months and then review the situation. Thanks for your advice.

[Tall_Allen]

Here's some info that my help you make a decision:

prostatecancer.news/2023/04...

[JohnInTheMiddle in reply to Tall_Allen]

Super thanks Tall_Allen for sharing this - I hadn't seen this article yet for some reason. This is a great article to study on the topic of ADT.

May I ask if you've published anything on the question of leading edge practices on pushing off evolution to ADT resistance? I'm on triplet therapy of course and I have been working hard on exercise.

[Tall_Allen in reply to JohnInTheMiddle]

Docetaxel reverses enzalutamide resistance:

prostatecancer.news/2022/10...

There are about half a dozen ways in which PCa becomes castration resistant, and medicines are in development or trials targeting each of those mechanisms. The problem is even if one mechanism is blocked, the others will compensate. So far, the best we've learned is to delay castration-resistance with stronger hormone therapies that kill off the most resistant clones.

[JohnInTheMiddle in reply to Tall_Allen]

More thanks Tall_Allen.

[John347 in reply to Tall_Allen]

Thank you Tall_Allen for the article. I will study it closely before making my decision.

[j-o-h-n]

A Preview of the final results on the ADT no/yes vacation survey.

86 No - VALID responses (55.5%)

69 Yes - VALID responses (44.5%)

155 Total VALID responses

Note: The responses above should NOT be construed as an endorsement of either for or against ADT vacations for our members. That decision is still the member's together with or without his medical team/advisers.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/07/2023 10:38 PM EST

[j-o-h-n]

Hey Rocket, You sending your wife to the Moon for a vacation? Shame 😩

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/07/2023 10:54 PM EST

[Professorgary]

My urologist told me of a patient of his that had a RP. Cancer came back and the guy refused radiation. Several years later he came to the doctor with severe back and hip pain. Psa over 7000 and cancer in bones. Got a Lupron shot and came back 3 mo. later and got another. Psa was 4. At 6 mo. Psa was 1. Guy left and doc didn’t see him for several more years until he returned with hip pain. Ran tests and cancer was clear. He just needed a hip replacement. Got his hip replaced and urologist never saw him again. Urologist did say that was a 1/1000 case.

[John347 in reply to Professorgary]

Thank you Professorgary. That's an interesting case.