A bit of rethinking of the standard of care for intermediate and high-risk PCa cases - of long-term ADT adjunctive and after high-dose radiation treatment.
Dr. Storey makes a case that long-term (33 months) of ADT treatment based on obsolete studies (studies with results from radiation treatments with ADT of 10-20 years ago) are not necessarily best for the patient and that the 5-year cure rates of 95% or more with intermediate-risk patients show high-dose radiation has a clear superiority to surgery.
This was a good read, especially since this question came up in my last feed from HealthUnlocked..
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Don_1213
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Excellent article. As a high risk PC patient, I'm having RT in a month (VMAT + SGRT). In the trial, they used IMRT which I understand is not as good as VMAT. The article stressed that 80 Greys gave better results than 70Gy. Does anyone know if VMAT uses 80Gy as standard?
First to clear things up - VMAT is a form of IMRT, and it's been around for a while. Some machines like the ones from Varian simply refer to it as "ARC" - I had 83 Gray of IG/IMRT/ARC - 45 treatments. I was a G10. At the time I had it done, it was on the most recent Varian machine varian.com/products/radioth... - it's capable of several "ARC" forms of treatment.
It could be said I had "VMAT" treatment (see article above) but my oncologist referred to it as IG/IMRT/ARC - and as I said - I had 83 Gray.. so the answer is - yes, VMAT treatment may do 80 Gray.
You may want to switch to estrogen patch therapy instead of Lupron ADT. Search for my posts on "estrogen". Estrogen patch therapy rapidly reduces testosterone (and PSA) to castrate levels. If you send me a private chat with your email address, I will send you 10 papers on estrogen patch therapy.
janebob99 - I get the feeling you're advocating a different treatment (estrogen patch) then the SOC, I've noticed your replies to multiple posts with estrogen patch information. In the case of this reply, I fail to see the relevance, especially since MY treatment is complete, and appears to have been successful.
Are you looking for confirmation that your treatment is the "right" treatment? I don't think anyone here would really want to say that, none of us are oncologists (that I know of..) we're all patients. It does appear that estrogen patch treatment may be viable for some men, and may provide some benefits to some men (such as faster recovery of T levels) - but notice the word "some", it doesn't seem it would apply in all cases, nor would is supplant ADT as a viable treatment option. ADT has worked for too many men too many times for it to be dismissed.
If what you're looking for is confirmation (I noticed you joined recently) - then I suggest that's between you and a qualified medical specialist, and doesn't need to be added to so many threads here. I don't think we'll be confirming. Is it interesting? Perhaps to some men. Is it a path men should take - perhaps for some men.
Best of luck whatever treatment options you decide to take. There isn't a huge amount of info in your bio so we don't have that to base suggestions/comments on. Good luck!
Sorry if I clogged up your mailbox with extraneous information...
There is a dearth of information about the use of transdermal estrogen that is relevant to most men in this forum. I'm getting lots of requests from men asking for more information about it. So, I think my posts have been helpful.
Older men who have completed treatment and have low testosterone and, consequently, low estrogen will also benefit from doing estrogen supplementation.
I'm a firm believer that there is a better way to do ADT than Lupron, etc. Estrogen treatment was the Standard of Care in the decades from 1950-1970, before Lupron was invented. Oral estrogen was dropped because of problems with blood clots. Modern transdermal estrogen doesn't have any problems with blood clots.
Estrogen castrates men to the same level, and faster, than Lupron ADT.
I do have an oncologist and endocrinologist with whom I'm talking about the benefits of estrogen. Most are simply unaware of this new delivery option.
I'm not interested in just SOC...I want the best care available and the best QoL. And, that includes looking at so-called "experimental" treatments .
There are a lot of men who post here that suffer greatly from Lupron ADT. I believe men can be treated without having to suffer the bad, and sometimes serious, side effects of Lupron ADT.
So, yes, I'm on a soapbox...but in the interest of getting the best care possible with the newest research available.
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My urologist after RT and ADT
Sequence of radiation and ADT
Prostatectomy with pre-ADT?
Adding ADT to external beam radiation only benefits unfavorable risk patients
