What is current norm for length of hormone therapy (ADT)?

How long does your Dr suggest that you need to be on ADT?

Two years but radiologist suggests that if numbers look good I can stop at 18 Months. My sense is from reading international medical literature that these lengths change as more research is published. I have no medical training but know that there is a move that for people my age- 82- therepy can be attenuated

Thanks. For High Risk the numbers I see are 1.5 to 3 years of ADT. So perhaps the 18 months is possible.

Found these numbers here.

I was assessed as high risk and completed 2 years of ADT.. currently on 7 month holiday and psa is undetectable.. outside of the night sweats life was ok… ✅ if it extends life .. I am doing it👍

I've finished 1 month of UCLA doctor-recommended 12-18 months hormone therapy (Orgovyx) for my Gleason 9 stage 2 PSA 30 single tumor.

No nodal involvment & no metastasis detected anywhere, entirely within prostate according to PSAM PET scan (80-90% reliable by my research).

And that's how I want it to stay until HDR Brachy next month. So I'm happy to report my PSA has dropped to 4 and testosterone has dropped from 454 to less than 6. Very effective!

Yes, hot flashes are annoying but worth the benefits & peace-of-mind.

I'll closely monitor PSA and testosterone for 1 year. Then I want another PSMA PET scan... and assess whether to continue Orgovyx.

The standard was 18-24 months. The reason is that the doctors were not certain of catching all the cancer cells with existing scanning at the time. Therefore in order to be sure, they carry on longer. On the other hand, there is also the concern of over treatment. With the use of PSMA Pet Scan, the doctors are more confident of getting the cancer sooner. So there is the tendency to reduce to less than 18 months.
Hope that makes sense. Dont mind me. I am just another layman.

That is the trend as I understand it. Can find spots on PSMA pet and radiate them. Possible cure vs old images where it was too late by the time the cancer showed up

That's a question you may not find a definitive answer from thus forum, your literature searches or your medical team.

Like this heterogeneous disease vice homogeneous, the answers will be all over the treatment map.

So, as others have said, I'm not trained, educated, certified as a medical expert . I have been on this journey ten years so do have experience.

My sensing is for those castrate resistant the consensus is "lifelong..."

For those not castrate resistant, clinical data - history, health, age combined with personal choices balancing quantity versus quality of life all come into the decision making process.

I have seen 6, 18, 24 and 36 as the predominate lengths.

In Jan 17 when I did triplet therapy, the plan was 24 months. Kwon agreed to stop at 18 given the clinical response.

In March 2023 when it came back, my radiologist and I thought SBRT and six months. My oncologist initially thought 24 months and an ARI.

We settled on 12 months, keep the ARI in reserve should Orgovyx and SBRT not drop the PSA to undetectable and keep it there.

As you can see from clinical history, it did and it has...at my nine month consult my urologist surprised me and asked if I would consider going months.

My instinctive reaction was....!

However, I said, let's discuss in April at the 12 month point and see what the clinical data says.

I can tell you what my answer is unless the labs in April show resistance....we're stopping at 12 for two reasons:

I want to reduce chances of resistance developing.

The fact that my PSA dropped to undetectable in the first three months is clinically significant, a harbinger, though not guarantee, of a durable remission.

So, we'll actively monitor, labs and consult every three months, decision criteria when to image and then the next treatment decision. How long will that off treatment be, don't know, neither does my oncologist, when I pressed him on the risk-benefit data supporting the additional six months, he could not answer.

I've been on this journey ten years, three actively on treatment, seven off. That is a function of my clinical history, no bone or organ involvement, nor castrate resistance...,and advances in imaging better informing treatment decisions.

So, I didn't answer your question, how long...I am not sure one of us can.

Hopefully I have given you some things to think about as you go through your decision making process.

Kevin

I am in a clinical trial at UCLA ( for high risk Gleason 9 CR advanced ) 6 months of lupron and Erleada, then RP, then 6 more months of these drugs. I have been off of the drugs for 15 months, PSA is is .01, T is 100. The drugs and the surgery were completely manageable. Presently 77 years old. My prognosis 30 months ago from my UCLA surgeon urologist was 4-5 years. Of course I wish to extend that as long as I am feeling satisfactory. My care at UCLA could not be better.

I was 72 1/2 years old when diagnosed. Initially, my treatment plan involved Zoladex and Abiraterone at a dosage of 1000 mg on an empty stomach for two years. Three months into this regimen, I underwent radiation therapy. Currently, after 14 months, my doctor has adjusted my Abiraterone dosage, reducing it to 250 mg to be taken after breakfast.