Questions about protocol changes regarding ADT from 2nd opinion.

[Eadgbe]

I was diagnosed with PC about 2 months ago. I received a 2nd opinion from John's Hopkins today and all cores had a different (slightly lower) Gleason scores than my local testing gave. However I do have the evidence of adenocarcinoma in the prostate and am starting on this road through RT (with an OAR barrier) and ADT scheduled next month.

My question: is there a difference between Eligard and Lupron? My reading says they are for "advanced prostate cancer." I'm not sure what that means. My cancer is still contained in the prostate it seems (a pet scan next week will determine if that's true). And if mine is not considered "advanced" do I still use them? Or are there milder drugs? Are the side effects noticeably different from one to the other?

I went to my urologist last week and he was going to give me a 9-month shot of Eligard even though I had not requested it. It was a miscommunication - and not the first with this office (I spent a fes lively days in ICU with sepsis from the transrectal biopsy I was told was as good as the transperineal one) so my epistemological trust in my urologist is a bit shaky.

[Tall_Allen]

What is your PSA and Gleason score (only Johns Hopkins counts)?

[Eadgbe in reply to Tall_Allen]

Last PSA was 15 (moving from 13, 3 months prior) , This is what was written on the report (I don't know what some of this lexicon means)

A-E Benign

F. Prostatic adenocarcinoma 3+3=6 (Grade group 1) involving 30% of 1 core

G-I Benign

J. Small focus of adenocarcinoma 3+3=6 Grade group 1 (involving less than 5% of one core)

K.Small focus of adenocarcinoma 3+4=7 (Grade Group 2) (involving less than 5% of one core)

Note: Cancer too small to accurately assign a percent of pattern 4

L. Prostatic adenocarcinoma 3+3=6 (Grade group 1) involving 5% of 1 core

M. Prostatic adenocarcinoma, Gleason score 3+4=7 (Grade group 2) involving 3 cores (10%, 10%, <5%) less that or equal to 5% Gleason pattern 4.

Pattern 4 in this case lacks large cribiform morphology.'

Grade Groups range from 1(most favorabe) to 5 (least favorable).

Your translation is appreciated and needed. RA and ADT planned.

Original question: "advanced prostate cancer"? Difference between Eligard and Lupron.

Thank You for your attention in this.

[Tall_Allen in reply to Eadgbe]

Your high PSA (over 10) puts you in the "unfavorable intermediate risk" category, even though your Gleason scores are more typical of "favorable intermediate risk.) For patients in your risk category, a short duration (6 months) of ADT has been found to improve radiation results.

There is currently a major clinical trial for patients in your risk category that you may want to sign up for. In it, patients get a Decipher genomic score from their biopsy tissue. Those who get an above average score (high likelihood of metastases) also get Nubeqa.

clinicaltrials.gov/study/NC...

I'm not sure whether you qualify, but it is worth checking out.

Eligard and Lupron are the same active ingredient (leuprolide), so it doesn't matter which you get.

[Eadgbe in reply to Tall_Allen]

Thanks. Not a candidate for a test (had melanoma about 15 years ago). Plus Nubeca would leave us penniless. It seems the protocol assigned to me is what you are suggesting, too - RA with 6 months ADT. Pet scan is a week, so I'll see what's up.

Many thanks again.

[Tall_Allen in reply to Eadgbe]

In clinical trials, there is no cost to patients for drugs.

[Magnus1964]

The advanced prostate cancer is generally cancer that has spread beyond the prostate.

If the cancer has gone beyond the prostate, surgery is generally not an option.

The difference between Eligard and Lupron, Tall Allen might provide some insight.

[watertender]

You may want to consider Orgovyx, side effects are generally milder. Not sure if your

insurance covers but they do have a program based on your income and you could possibly

qualify for free meds. I see you are probably on Medicare so injectables (Lupron etc) are

covered under that program. Good luck with whichever road you choose.

[Photographerhere]

ADT is not easy.hot flashes, tiredness, loss of libido. My diagnosis was intermediate to agressive, but contained within prostate. But my top doc has me on ADT anyway as he say it decrease recurrence by a lot. Lots of evidence to that fact esp with advanced cancer.

[805guy in reply to Photographerhere]

What was prescribed for your ADT and the duration?

[Photographerhere in reply to 805guy]

I am in my fourth month of Lupron of out 12 months prescribed by UCLA docs

[WinniethePooch in reply to Photographerhere]

My husband has the same contained Pca but his UCLA doctor has started him on Degarelix?

[Photographerhere in reply to WinniethePooch]

A lot depend on age, pre ious health issues,weight, blood pressure and such. I don’t think there is a one size fit most. For me, it was SBRT and then one year of lupron—many go on it two or three years depending on how advanced and aggressive their pc was.

[WinniethePooch in reply to Photographerhere]

Thanks.