Castration resistant PC CRPC -Neuroendocrine PC linked 2 ADT ?

It was announced at one of the recent conferences that staying on ADT, Zytiga or one of the lutamide drugs could lead to neuroendocrine cancer if you were on them for more than four years. It Increased the likelihood of getting it not guaranteed it.

I was on Lupron for seven years and then Orgovyx for a year and have not gotten it.

I wonder if it's just that improved ADT, Zytiga, and/or the -lutamides keep people with advanced PCa alive long enough that neuroendocrine mutations become more likely.

Let me answer your other question. A tremendous number of people develop CRPC after being on ADT. In my case, I became castrate resistance about 2 1/2 years after starting ADT. This is not uncommon. I know a couple of hundred people that attend the advanced prostate cancer meetings, with a group I attend with, have CRPC. Of course they don’t all attend at once but they have shown up over the last four years during meetings I attend weekly.

People who get neuroendocrine are a very small percentage of the prostate cancer survivors.

Thanks for the extra info. I guess we just have to get used to living with bigger risks.

My emergency spinal surgery in 2021 was drastic, and could have had a very bad outcome — as it was, even with successful sugery I had months of serious cascading medical issues afterwards before my body rebalanced, and some consequences are with me permanently.

... and yet, and yet ...

While I don't think they'd ever agree to a risky operation like that just to treat a stage-4 cancer metastasis, now that the risk (and repercussions) are far in my rearview mirror, one oncology resident has even suggested to me that the operation might have improved my overall-survival prospects considerably. I won't know for sure until it's too late to matter.

Life's unpredictable like that (and not just for cancer patients). Might as well enjoy the ride.