ADT before and after IMRT

[Keeper70]

So my husband had 5 Cycles of Taxotere in 2019, was first line treatment, started Lupron fall of 2019, then PSA creeped up and MO started him on Casadex. Worked till 2022 when PSMA scan showed lymph nodes, started Zytiga in November 2022 , started with 44 Tomotherapy/IMRT in Feb 2023, My question is how long after all this radiation does he need to continue ADT he’s been on it for 4 1/2 years prior to radiation? RO says quit all now and manage PSA. Thoughts! I appreciate it

[Tall_Allen]

He will always need ADT. The radiation slowed the cancer, but did not cure him. If he needs a break from ADT, that is up to him, but he should consider the risks:

prostatecancer.news/2023/04...

[treedown]

Manage the PSA how? As we have all been told PSA is not cancer but would be interested in the details of his plan to manage PSA.Having said that I know how he feels and have been on ADT less time than him but with recurrence have accepted that I will be on it for life now. If I thought for a minute I could safely stop for a period of time, I would.

[Keeper70 in reply to treedown]

Hi treedown,

we got home from Arizona in April after 44 radiation treatments, RO gave him “curative dose”, when we came back his PSA has now dropped to 0.01 and testosterone is less than 7

The RO wants him to end all ADT, Continue to check PSA and testosterone, routine PSMA pet scans

Needless to say MO (soc)and RO are at odds

By the way this RO was oligometastatic and cured himself, It’s a tough decision and we know the risks , thanks for your thoughts

[treedown in reply to Keeper70]

Its certainly the only way to know if curative treatment worked. Good luck I hope he is cured.

[Seasid in reply to treedown]

His testosterone may never recover. It is like a lottery.

[treedown in reply to Seasid]

That is a risk. The upside to slower T recovery may be longer time before recurrence. But if cured none of that will be a issue and he will have all the time in the world for T to recover. Mine took 3 months butike you said a lottery.

[Seasid in reply to Seasid]

I am on Degarelix and I may have a better chance that my testosterone recovers after stopping ADT. I will not stop my ADT. It could be suicidal as I am polymetastatic in my spine and neck.

[j-o-h-n]

Use a two headed coin to decide (u.s. 25 cent Washington quarter).............Always call heads,

Washington's head one side and the Eagle's head on the other.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/25/2023 3:07 PM DST