ADT or no ADT: Diagnosed with 4+3, mri... - Prostate Cancer N...

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ADT or no ADT

progman profile image
8 Replies

Diagnosed with 4+3, mri shows 2 lesions in prostate only. Starting proton therapy soon, urologist and oncologist recommend 6 mos of ADT. The latest stody for unfavorable is a difference of .7 years?( hard to understand the study results). Trying to make the decision whether or not to do the ADT.

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progman
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8 Replies
Tall_Allen profile image
Tall_Allen

Yes, 6 months of adjuvant ADT is standard of care for unfavorable intermediate risk.

I'm not sure which study you are referring to (there have been a couple).:

ejcancer.com/article/S0959-...

jamanetwork.com/journals/ja...

As you see, they both show that adding short-term ADT to radiation can cure prostate cancer, whereas it is not cured without ADT.

maley2711 profile image
maley2711

My understanding is that the probability of "cure" increases with the use of ADT.....not to say that radiation alone will not work for you.

Seasid profile image
Seasid

i didn't feel any difference after 6 months on ADT.

You shouldn't have any concerns.

Just do that 6 months of ADT so you are cured.

Lingbed profile image
Lingbed

All 4+3s are not created equal. Weighing other factors such as pathology sub type, volume of cancer and volume of grade 4, PSMA results, and Genomics testing can help you decide. The standard of care doesn’t, understandably, go beyond the high level data. I was 4+3 and my well know radiologist was clear that it don’t need it. I did HDR Brachytherapy.

BB_1 profile image
BB_1

I am a 3 +4 with two lesions. One really big. Hope to start radiation therapy soon, maybe December. Had a set back with the gel placement on Oct. 3. Anyway, ADT was discussed but no decision made. 6 month was suggested but I said I would do monthly or a three month. I am still on a holding pattern.

JWS13 profile image
JWS13 in reply to BB_1

what kind of setback did you have with spaceoar gel? which doc did yo see at what health facility? Ucla? Ucsd?

Horse12888 profile image
Horse12888

I hated ADT, but even I would roll with 6 months, especially now that there is Orgovyx, and you'll start feeling better a few weeks after it's over.

cancerfox profile image
cancerfox

ADT definitely sucks, but 6 months is a relatively short period of time and would probably be worth it. Plus it takes an additional 2 to 3 months for your T to return after the 6 month treatment period ends. All the best!

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