My PSA is 5.3, Gleason (3+4) 7 and Decipher .61. Do I need ADT?

Hi @okiedokie555, I hope you have seen the many helpful replies from fellow prostate cancer members. How are you doing? Have you made any decisions about your treatment plan and ADT?

So, I talked about the dizzying array of options, the need to do your homework, infirm yourself so that you can discuss choices with your medical team and then make a decision with their input .

Here's an example of trying to determine what to do - https://www.urotoday.com/video-lectures/state-of-the-art-interdisciplinary-management-of-prostate-cancer/video/3899-an-overview-of-strategies-and-therapeutic-advances-in-metastatic-prostate-cancer-rana-mckay.html

Great information, challenging to sift through it, determine what may be applicable, and discuss with your medical team.

I say challenging, but important!

None of my doctors suggested adt, neither as a treatment or supplementary treatment; however each individual may have different recommendations for treatments from their Drs depending on their specific characteristics, personal life style priorities and needs.

I just finished MRI guided sbrt for my prostate cancer after over 1 year of visiting mutliple urologists, radiatioon oncologists, and medical oncologists, extensive research with American Cancer Society (excellent and helpful), NCCN, NIH, and various prostate cancer foundations. My assessment is that every individual will make their own decision based on their comfort with the various treatment options and anticipated side effects, with assistance from their spouse, physician, and or family. All statistics and data supports equal efficaciousness eradicating cancer contained within the prostate to approxiamately 95%. I was no longer a candidate to remain at active surveillance which had been the initial guidance in the prior six months.

I had a gleason 3 + 4 in 15% of 2 cores, and 3 + 3 in the balance of the same cores. (this was a increase changed from 3 + 3 and a previous low dna oncoyte score ) I had a psa of 6.1 and a dna oncocyte score of 32. I was advised by multiple urologists and oncologists to decide on treatment- either surgery or radiation since my cells indicated the type that would could grow. Four urologists suggested surgery (and 1 urologist subsequently also was supported my decision for 5 treatment sbrt MRI guided. Three radiation oncologists incicated radiation treatment would be equally efficatious, and two medical oncologists supported my decision for radiation.

I just finished my sbrt MRI guided treatment and am very pleased with my decision. I do have remaining anticipated side effects which appear to be diminishing.

I hope this is helpful.

I do not want to undergo ADT. The side effects scare me. With a Decipher score of .61, do I really need it?

Patient Data 5-25-24

Age 68, High blood pressure, pre diabetes
Last three PSA scores 5.7, 5.8, 5.3
Decipher score .61
Currently undergoing Proton Therapy. Finished 10 of 29 treatments

Biopsy results:
A. Left lateral base of prostate, needle core biopsy:
-Prostatic glands and stroma without abnormality

B. Left lateral mid prostate, needle core biopsy:
-Prostatic glands and stroma without abnormality

C. Left lateral apex of prostate, needle core biopsy:
-Prostatic glands and stroma without abnormality

D. Left medial base of prostate, needle core biopsy:
-Prostatic adenocarcinoma, Gleason score 6 (3+3), grade group 1
-Tumor involves 0.5 mm of a single core biopsy (5%)

E. Left medial mid prostate, needle core biopsy:
-Focal chronic prostatitis

F. Left medial apex of prostate, needle core biopsy:
-Prostatic glands and stroma without abnormality

G. Right medial base of prostate, needle core biopsy:
Prostatic adenocarcinoma, Gleason score 6 (3+3), grade group 1
-Tumor involves 1 mm of a single core biopsy (8%)

H. Right medial mid prostate, needle core biopsy:
-Prostatic glands and stroma without abnormality

I. Right medial apex of prostate, needle core biopsy:
-Prostatic adenocarcinoma, Gleason score 7 (3+4), grade group 2
-Pattern 4 occupies approximately 30% of tumor
-Tumor involves 7 mm of a single core biopsy (75%)

J. Right lateral base of prostate, needle core biopsy:
-Prostatic adenocarcinoma, Gleason score 6 (3+3), grade group 1
-Tumor involves 0.5 mm of a single biopsy (6%)

K. Right lateral mid prostate, needle core biopsy:
-Focal chronic and acute prostatitis

L. Right lateral apex of prostate, needle core biopsy:
-Focal chronic and acute prostatitis

You have made your decision; have confidence in it.

ADT sucks. I took it for 4 mos as part of my salvage treatment for persistent elevated PSA after RP for G 9 PCa.

Should it have been longer? No one really knows.

Residual doubts are one of my treatment side effects.

Clearly from this and other posted threads, "some do and some don't".

You appear to have low level disease that you are treating in an appropriate manner.

Try to have confidence and best wishes.

We have similar PSA/Gleason numbers. I've consulted a Radiation Oncologist and a Urologist. The Urologist advised that I take ADT with radiation therapy but the Radiation Oncologist said that there's not much benefit for me to take it.

At 72 years old for me, orchiectomy with reconstruction (implants) was my choice for ADT.
3 months post op and very happy with the outcome. All my numbers are plummeting.

We also supplemented the ADT with ASI (250mg abiraterone/zytiga and 5mg prednisone).
Also doing 6 docetaxel. infusions 21 days apart. 2 down and four to go.

So far, so good.

Where did you receive these VMRT treatments?

Beth Israel Deaconess in Plymouth MA.