ADT or not for favourable intermediate risk with SBRT

[pd63]

Currently on AS, have repeat tp biopsy in October, this is routine for AS.Treatment advice, if I choose is SBRT but no ADT due to CVD risk as I have chads score 2, had 1 previous stroke in Feb 18 with full recovery, diagnosed May 2020 with paroxysmal AF, had 1 episode since so low burden, bisoprolol seems to keep it under wraps so very low burden.

No comorbidites, BP/blood sugars etc. all normal, exercise regular with swim 2000m 4 times/week and regular hill walking

Comments please

[Tall_Allen]

Why would you have ADT after AS?

[pd63 in reply to Tall_Allen]

If I decide to have treatment that's all, just asking if adt with sbrt has benefits for favourable intermediate

[Tall_Allen in reply to pd63]

No known benefit.

[pd63 in reply to Tall_Allen]

Thk u

[Photographerhere in reply to pd63]

I would check with a radiation oncologist. SBRT is enhanced with ADT, not for three years for all cases.

[Horse12888]

There is a study showing no benefit to low risk cases. Don't get talked into it.

[Hidden]

look up the side effects of ADT and Low T and make your own decision about it. I will always refuse ADT myself, unless it ever metastasizes. And then, it would be a different story.

[chrisNYC]

i did ADT for 2 months prior to SBRT bc they saw some potential extra capsulary extension on my final mri. was proposed to "shrink" back the cancer and make SBRT more effective. i suppose it did. i didnt have many effects from 2 months, though i lost 10lbs of muscle. all my T came back.... BUT, i did develop a mild form of peyronies disease from the process and there is literature that ADT combined with Radiation can cause vascular injury... really really not happy about it but perhaps in my case the ADT was a penny foolish and a pound wise, hard to know... all that said, i would avoid it unless it is irresponsible to do so....

good luck, CDG

[pd63 in reply to chrisNYC]

Oncologist advised not to do adt if I choose treatment, currently on AS and having repeat tp biopsy in October, my prognosis is treatment possibly in the future just postponing maybe , hospital AS protocol is rigid enough for me to continue.Long term outcome is no worse mortality risk if treated or on AS, some higher risk of mesastasize on AS, CVD probably get me first anyway

[chrisNYC in reply to pd63]

i was initially on AS a long period of time before things began to worsen. for some guys, AS is more anxiety producing than selecting a treatment, because of the dread of the unknown... its like waiting for the executioner. doesnt feel proactive.

i was NOT that guy. i had no problem with AS, pushed cancer out of my mind for 3 months after every PSA test and thanked my stars i was still in the protocol.

PC can make you oddly thankful because you become acutely aware of some of the worse alternatives...

[JWS13 in reply to chrisNYC]

did you get your erctions and orgasm's back..?

[chrisNYC in reply to JWS13]

i am post SBRT and have no problem with erections (am on 5mg cialis per day, but even when i forget it is not an issue). Orgasms nearly entirely dry.

my biggest concern (noted elsewhere on this site) is that i developed a mild case of peyronies disease (a vascular condition wherein not all the blood vessels in your penis still engorge, the ones that do inflater around the ones that dont and can cause a bend to the penis)... i have a mild bend and have lost some size ... probably my own fault identifying with my package too much in life, but it has been a bit of a psychological hurdle... i am still perfectly average or better but it screws with your head fer sure.

[Mikeygg in reply to chrisNYC]

I finished 28 SBRT and two 3 month Leuprolide shots(ADT). If I had to do over no way would I do ADT. 6 months after shots and I’m still suffering the side effects. It’s made a pretty vibrant person turn into a broken old man. I did walk, I did lift weights, nothing has helped. These Dr’s all follow the same treatment and say all will be well, WELL THATS MY STORY,GOOD LUCK.

[pd63 in reply to Mikeygg]

We're you favourable intermediate, if so why ADT?

[Mikeygg in reply to pd63]

I was diagnosed 3/4 =7. 3/3 =6. Had 2nd opinion from JH. 3+4 stayed the same. 3+3 was downgraded to no cancer. So I guess you could say the 3+4=7 could be called intermediate/ favorable. At 75 yrs old I didn’t want surgery and my urologist sent me on my way for SBRT. It was there while having radiation they highly recommended ADT. Against my better judgment I had the 2 3 months shots. Looking back in hindsight I should have said no.. It’s been a bad trip so far for me, but everyone has to investigate the side effects and make there own decision. Do your research. Again Good Luck with your journey.

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