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