ADT for a year?

[Photographerhere]

Had intermediate grade PC no spread, had SBRT. Three months out my Psa is .03. Am on Lupron for the fourth month out of a projected 12 month stint. Do docs ever say, six or nine months is enough? Testosterone at 6 right now.

[Tall_Allen]

4-6 months adjuvant ADT is SOC for unfavorable intermediate risk radiation.

prostatecancer.news/2020/09...

[Photographerhere in reply to Tall_Allen]

I am hoping my doc agrrees that six months for me is enough. I found this paper which You might also find interesting jamanetwork.com/journals/ja...

[Tall_Allen in reply to Photographerhere]

That's for high-risk.

[Photographerhere in reply to Tall_Allen]

Yes for high risk. I had a 6.8psa, 3+4, 3+4 , 4+3, and a 4+4. PSMA showed localized. I think i am intermediate to high risk. Not sure what doc will say. You think intermediate or high? Psa now .03, testosterone 6.

[maley2711 in reply to Photographerhere]

This also might be of interest.....

" ASTRO 2022: Optimal Duration of ADT with Definitive Radiotherapy for Prostate Cancer: An Individual Patient Data (IPD) Meta-Analysis from the International MARCAP Consortium "

urotoday.com/conference-hig...

Interesting is the use of overall survival as the goal vs metastasis-free survival....for the latter, the answer may be infinite duration?Surprise surprise....as duration increases, so does other cause mortality ......thus infinite duration NOT the answer for overall survival, which seems to make some sense? The graph showing overall survival for the mix of intermediate and high risk patients seems to indicate 19 months duration for optimal overall survival......but looking at the early duration benefit, you get most of the benefit with "just" 12 mo. I have n't yet looked for a more detailed breakdown by intermediate and high risk, or by Gleason score, for patients in this MARCAP study.

Another study discusses different durations , dependent on what nadir is achieved. As the years roll on, hopefully we wil have even better ways of individualizing ADT duration ???

Let us know the results of your consult!!

[Tall_Allen]

No. The GS4+4 puts you squarely in the high risk category. You have to have 26 months of ADT.

prostatecancer.news/2022/01...

Risk categories are usually by NCCN protocols.

[Lizzo30 in reply to Tall_Allen]

If testosterone is such a risk factor how come young men with peak testosterone aren't more at risk of prostate cancer ?

[Tall_Allen in reply to Lizzo30]

There is a big difference in giving testosterone to a man who is healthy and giving it to a man who already has metastatic prostate cancer. Prostate cancer cells feed on testosterone.

[Lizzo30 in reply to Tall_Allen]

It seems the wild yam I take for menopause could be an alternative to ADT bc wild yam doesn't just counter androgens it inhibits PCncbi.nlm.nih.gov/pmc/articl...

[Tall_Allen in reply to Lizzo30]

Don’t give your husband impure chemicals like that in unknown amounts. It is covered by insurance.

[Photographerhere]

i see big doc on wednday. We’ll see what he says

[Hidden]

I was given a 4 month shot of Lupron just prior to my IMRT radiation and that was it. Your doc might just be overly cautious. You can take the risk and decide for yourself if you want to allow more. I was unfavorable intermediate risk with tumor confined to the prostate.

[Magnus1964]

Why are you placing a limit on Lupron? If a treatment is working why stop. The goal here should be to get as much out of a treatment as you can.

[j-o-h-n]

Holy Shit............... for a whole year?

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/11/2023 2:36 PM - Remember

[OldVTGuy]

Watch the videos from Dr. Sholtz of PCRI when it comes to managing high risk disease that have come out in the past 6-12 months. He clearly questions the NCCM guidelines on ADT duration due to the advent of PSMA PET scans. My RO is saying the same thing and says “at least 12 months for high risk disease” but not necessarily 24 unless you really want it. I for one certainly believe ADT does long term damage to the rest of your body and thus it’s a trade off everyone needs to consider for themselves. Unfortunately it does not appear to be an exact science.

[Jpl506]

Who is your UCLA Dr? Mine is Dr. Amar Kishan, author of the 26 month ADT study and he told me that 5 session SBRT is akin to HDR BBT and the 26 month duration doesn’t apply. I was on month 25 when I learned this so it didn’t matter in my case.

[photographerisme in reply to Jpl506]

Kishan is my doc as well. 5 sessions SBRT. Been on Lupron for 4 months. Having lots of lousy side effects. Meeting with him Wednesday. Hoping for a reprieve from lupron--but i doubt it. No spread or metastasis

[Photographerhere in reply to Jpl506]

i am a AK patient as well. had 5 session sbrt and now on ADT for one year. Good luck on your journey--we all need it

[photographerisme]

Kishan is my doc as well. 5 sessions SBRT. Been on Lupron for 4 months. Having lots of lousy side effects. Meeting with him Wednesday. Hoping for a reprieve from lupron--but i doubt it. No spread or metastasis