given a choice about duration of ADT

[Photographerhere]

Tall Allen and others. Clean PSMA, , 3+4, 3+4, and 4+3., biopsy. 77yrs old, hit gym daily but have significant side effects of lupron..

Being treated at Comprensive cancer center. Plan was one year of Lupron. After five SBRT, and nine months on adt, my doc is willing to let me terminate my Lupron, or just a one or two monthly shots. So i am being given the choice of nine ten eleven or the full 12 months of ADT. Doc’s comment, was, I am not opposed to shortening the duration as the increases to longevity are small because of the extra months.

I am trying to weigh the 2 or three percent statistical advantage against quality of life, and faster recovery. Am interested in your thoughts. Brian Jarvis, Tallallen, and others.

[ToolBeltZia]

Congratulations. The question is, how are you tolerating ADT? No problem.....stay the course. Moderate problems....go a month or two. Absolutely miserable.....bail.

[Tall_Allen]

On a previous post, you wrote that you had GS 4+4. Did you forget?

[Photographerhere in reply to Tall_Allen]

Must be the lupron. :).

What do you think? Doc is as knowledgeable as they get, and he is ok with shortening. As he said, you only gain a couple of percent, and he is leaving it up to me. Have weight gain, hot flashes,,utter exhaustion late in the day, no libido.

[janebob99 in reply to Photographerhere]

I recently posted about the use of transdermal estrogen patches (cheap) to counteract most of the side effects of Lupron, etc. The only downside is gynecomastia in about 1/3 of the men.

[dhccpa in reply to janebob99]

Can't Tamoxifen control that?

[janebob99 in reply to dhccpa]

Perhaps. I'd have to look it up. I don't have any knowledge about it's use.

[janebob99 in reply to dhccpa]

Tamoxifen is an anti-estrogenic drug. It might negate the beneficial effects of doing estrogen therapy instead of Lupron, etc.. I would be concerned about using Tamoxifen while doing estrogen patch therapy.

[dhccpa in reply to janebob99]

Maybe so. I thought some had recommended even with estrogen, but maybe it was something else.

[Mike58 in reply to Photographerhere]

Is it Flash or Flush ----- I am at a loss as I've heard both 😜

[MarkS in reply to Mike58]

It would seem that it's hot flush in the UK and NZ and hot flash in the States.

[Mike58 in reply to MarkS]

Ok - thanks, that may be why we see both being said from time to time.

[Photographerhere in reply to Tall_Allen]

Tall_Allen, several months ago you were recruiting for a support group in Los Angeles. Did it ever get started? Are you taking new members.

[Tall_Allen in reply to Photographerhere]

I have 3 support groups in Los Angeles: advanced PCa, gay/bi, general. I prefer live meetings (small groups, individual attention - 2 hours, once a month), although I make some exceptions.

[Photographerhere in reply to Tall_Allen]

I think i would fit best in the “general”. Could easily make a once a month meeting in person depending on time and place. If you want to chat offline hit me up.

[Tall_Allen]

All I can tell you is what the data say:

prostatecancer.news/2021/06...

Unfortunately, there isn't a lot of data for SBRT for high risk patients.

[Nusch]

Three more months seem to be doable for you. Come on, give yourself a kick and go for it. Create a countdown and count the days, switch to plant based diet plus fish and extend your exercising to reduce weight and fight fatigue. Just around 90 days, you will not regret it and then your side effects are history. Good luck!

[Photographerhere in reply to Nusch]

We are warriors. I am in for the full duration. Side effects be damned; pc be damned. Dose me again with some of those radiation waves

[Nusch in reply to Photographerhere]

That’s a warriors attitude! You never walk alone, we are all suffering. And come here to this forum for a talk, advice or complaint whenever you feel it’s doing you good. All the very best - I’m just in the last month of 24.

[maley2711]

What your RO is saying seems to align with this 2022 presentation......

urotoday.com/conference-hig...

A U Michigan prof in a 2019 presentation gave pretty much the same counsel....and I remember the case he mentioned as making a huge impression on him..... a wife who said she could no longer recognize her husband after prolonged ADT that accompanied RT. I think that case was a man who received hypofractionation, not SBRT. The prof showed a slide similar to graph in above link.... a few percent gain in survival percentage when surpassing 12 months. The above summarizes that metastasis free survival seems to increase marginally as ADT is extended out basically forever, but at some point OS actually decreases......impact of ADT. The above concluded 18 months based on OS, but dramatic flattening of benefit curve as ADT passes 10-12 months. Some promnent Docs involved in the data manipulation covering thousands of patients.

[dhccpa in reply to maley2711]

Makes one wonder about its indefinite use in metastatic PCa. Much riskier, of course.

[Scooter22]

I did 2 yrs. of Orgovyx. ADT does wear on us. I’m a retired Phys. Ed. Instructor so I was & still am a consistent exerciser. I lost strength, libido, energy but I continued a modicum of exercise throughout. I wanted to quit the adt at the 18 mo. interval but my MO noted a 1-2 % increase in success rate. I decided, along with my wife to do his recommended 2 yrs. I was Intermediate unfavorable. My nadir psa reading at the 2 yr. mark was .01 & at 3 mo. follow up post adt it was .1

For me, I decided that if I had a recurrence & did not complete my MO’s recommended 2 yrs. of adt I would forever 2nd guess that decision. As of now I’m glad I completed the 2 yrs.. I’m proud of myself for winning that fight. Check out Orgovyx if you can. I was never on Lupron but I’ve heard Orgovyx is easier. I think anyone can do it but you MUST include exercise to mitigate some of the negative effects of the adt.

[j-o-h-n in reply to Scooter22]

So Gym, what is your age?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/11/2024 5:00 PM EST

[Photographerhere in reply to j-o-h-n]

77. But behave like a 24 yr old.

[MarkS]

I'm not sure where the 2-3% statistical advantage of longer adt treatment comes from. In TA's link above, the biochemical recurrence-free survival (bRFS) in columns 3 & 4 after 5 years is 76% for 4 months adt treatment and 88% for 28m treatment. That's a halving of the rate of recurrence. That seems pretty significant to me.

[Photographerhere]

Interesting thought. I should go to Las Vegas since i am beating the odds

[j-o-h-n]

So don't let it stay in Vegas... what is your age?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/11/2024 4:58 PM EST

[cancerfox]

You made it this far, what is another 3 months? At least you wouldn't be second guessing yourself in the future if something goes south. 🦊