Tri modality conclusion end of ADT nervous

[Yokohama2023]

A long journey.. Lutron , bicalutamide .. from start last year in June .. brachytherapy.. in October… 15 booster LiNac in Dec/Jan .. doctor ..in Japan said can stop hormone treatment but he sort of front loaded the ADT before radiation 5 months.My second opinion initially said to embrace adjuvant ADT .. I’m 4+3 unfavorable ..no PSMA scans available yet here…though Osaka university just started.. with over 9 months of ADT I’m stopping .. doctor said ok and didn’t recommend the last two months ..anyone else get nervous stoping the ADT ? When to say it’s enough ? Looking forward to maybe some testosterone and a life like before this diagnosis.

[Mike1971]

Hi Yokohama2023,

I would never recommend anyone with advanced PC to stop ADT early due to how our cancer works. Having that said, I fully understand anyone who still decides to do so since I stopped a few months earlier myself (I was on ADT for two years).

When to say it’s enough? Well, ideally never as per above. But for me - and my doctor - enough was when my body weight had dropped to 120 lbs from my normal and fairly fit 180 lbs and I felt more dead than alive.

* Yes, it is scary and nervous at times. Especially when waiting for the latest test results.

* You’ll never know if it was the right decision.

* My testosterone came back pretty quickly, and for me it was like getting my life back.

* If you decide to end ADT early, keep an eye on PSA and Testosterone. If you are unlucky and testosterone never really recovers much, perhaps it’s then better to go back on ADT.

* And if you decide to stop ADT early, make sure you enjoy the time off it. If it just creates anxiety and too much negative emotions, perhaps it’s better to stay on ADT.

One question though:

Since you have Gleason 4+3, is that within the curable possibility? If it is, I would of course urge you to try to complete the intended ADT duration.

[GP24]

If your PSA value is very low now, you could change to intermittent ADT.

[Justfor_]

My take: Stop Lupron, keep taking Bicalutamide while monitoring your PSA as Testosterone re-establishes to physiological levels. If PSA stays low, adjust Bicalutamide dosage.

FYI, I am implementing the Bicalutamide dosage adjustment part with excellent results:

healthunlocked.com/prostate...

[Tall_Allen]

Were you diagnosed with advanced PCa, or are you just posting in the wrong place?

[maley2711]

I believe most studies have shown adjuvant provides much more benefit than pre-RT...however, you had brachy, and most studies have shown ADT is less of a factor , duration-wise, than with external radiation. There is another site for non-metastatic guys, but you are welcome here too...anyplace a man believes he will find help!!!!!!!!!

[maley2711]

Here is that other forum.....

healthunlocked.com/prostate...

[Yokohama2023 in reply to maley2711]

Thanks

[maley2711]

You might try estradiol patches or gel to perhaps still benefit from low T but with maybe better QOL??? It is difficult here to find practitioners who will agree to that.....but Japan? Another researcher here...PhD, is using Dutasteride as part of his self-designed non-SOC approach.

I don't have extensive knowledge of either!!!

[Yokohama2023]

My bad sorry this forum defaults in my view and I have received the best feedback here..to be honest not sure if my prognosis is worse than diagnosed…very high PSA score since I didn’t have access to a PSMA pet scan .. so assume all this info may be relevant to me at some point. It’s difficult as I’m not in my native country and not completely bilingual yet alone medicalese.. wish you all the best .

[Horse12888]

Through medical science understands the broad strokes here, they don't have it down to the effects of a couple of months in any direction.

8 years ago, I quit ADT 12 months early because I was so miserable I wanted to die. Was that a smart decision? My MO didn't think so, but I'm sure he realized he could a call from my wife saying that his patient had put a gun to his head, and therefore won't be requiring any more medical services.

Bottom line: don't sweat a few months here or there.

[j-o-h-n in reply to Horse12888]

See Pca makes you crazy and forgetful......... you were going to part your hair with a gun. Geez I'm thinking of using a red Swiss Army Knife....

Good Luck, Good Health and Good Humor.

j-o-h-n