ADT or no ADT

[progman]

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.

[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]

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]

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]

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]

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 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]

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]

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!