Intermittent Hormone Therapy (IHT): How is it working for you?

Here is a link to an article( not the article Dr Schulz referring to):
https://pmc.ncbi.nlm.nih.gov/articles/PMC7654677/

Very interesting and has a lot of data over time. In a nutshell, once your PSA is less than .2, the author says you can try intermittent ADT, but only if you have no metastases.
You can do this cycle several times, but some cases become castrate resistant because of IADT so there is that risk.
I guess you would have to go off ADT and then see how long it takes for your PSA to rise. Rise to WHAT is the real issue. The author mentions a PSA of 3 (as opposed to the original level of 6) but I would personally be freaked out if my PSA went from .2 to 3 in less than 18 months. Don’t even ask me where I got that number - it just seems like a reasonable amount of time to watch your PSA go up by an order of FIFTEEN times from its lowest value before you go back on ADT. That scenario would not bode well for future cycling. However, if it took 5 YEARS to reach 3, that would indicate a fairly low aggressive PCa cell and a more favorable environment to repeat the cycle. It’s a process, that’s for sure….Just my two cents!

That is a great summary of the article! Dr Schulz says when your PSA reached a predetermined level, say a level of 2, you go back on ADT after PSAMA/PET scan.

Well, I think 2 would make me a lot more comfortable; even though there are always outliers, a PSA of 2.0 rarely will show metastasis and we both know how quickly Orgovyx will beat that number down to undetectable.
I think you are planning to do this, yes?

My PSMA showed probable cancer in the prostate (which was heavily radiated 4 years ago) but that it has not metastasized anywhere else. My urologist thinks this is great news! All I have to do now is take Lupron for the rest of my life, and I'll live happily ever after.

Hmmm. I suppose I should be thankful. Anyway, I just got my injection, so now I have some time to think about other options.

What makes you think you be on Hormone therapy continuously even if your PSA goes down to undetectable level? I am surprised your oncologist didn't switch you to Orgovyx?

Yes, not sure when to go off Orgovyx. I may want to tough it out until 12 months (April 1st).

Hey Bluegill, sorry about your situation. My friend was recently treated at Sloan, here on Long Island, NY. He had 5 sessions of SBRT (cyberknife type) and the RO said that if it ever failed he could still do seeds. Since your cancer is still inside the gland, might that be an option for you?

I see from one of your previous posts that you received 6 weeks of radiation - not SBRT. But even so, seeds confined to the prostate really should not affect any of the surrounding tissues.
You probably will require a gel spacer, however, to protect the rectum. Personally, I would get at least 3 opinions on this even if you have to go back on Lupron for a year. Best

Planning adt holiday after 2yrs orgovyx/arbiterone/prednisone. Had surgery 12/22.Recurrence @5 wks1.8psa then 2.3 a month later. Was going to just stop but Kwons group wants petscan and bloodwork prior to stopping so that nothing is going on that would explode when the adt stops. The MD Anderson study concluded that adt holiday outcomes were not inferior to constant adt. Good luck to all on this journey of intermittent adt.