Additional information for PCa patients under AS (active surveillance) regarding the length of ADT and PSA nadir achieved, versus outcomes. Biochemical failure-free survival (BCFFS), clinical failure-free survival, distant metastasis-free survival, cancer-specific survival, and overall survival (OS) rates at 5 years were 91.1 %, 95.4%, 96.9%, 99.5%, and 89.1 %, respectively. This study is small at 195 patients but the ‘p factors,’ the probability that the outcomes were wrong, are very low! Not mentioned is piling on surgery before sRT (salvage radiation) / aRT (adjuvant radiation), plus long term (>1 year) adjuvant ADT.
I had sRT with a PSA of 0.13; my Dr considered this to be BCF (biochemical failure) given my pathology; I have always looked at my treatment as aRT as my PSA was not higher than 0.20, 6 weeks post RP (prostatectomy). I was also on ADT a total of 21 months reaching a nadir of 0.001 for some months...based on this study it should improve my odds of having better outcomes. I am now 9 months into my ADT vacation; dont know how this will develop.
I have always stated that ADT can be a benefit to many PCa patients, but its effects are not fully explained to men before they take it. These impacts are discussed by me elsewhere. This publication further highlights, for some men, the benefits of ADT treatment. Know first that you will benefit from ADT, then understand fully its impacts, then proceed! The worst thing you can do with PCa is nothing…this disease does not get better with time.
