Connect
← Return to Gleason 7 (4+3) radiation, but ADT also? Over treatment?
Discussion
Gleason 7 (4+3) radiation, but ADT also? Over treatment?
Prostate Cancer | Last Active: 1 day ago | Replies (65)Comment receiving replies
I have similar concerns. In the following medical journal article (https://pmc.ncbi.nlm.nih.gov/articles/PMC10949134/), the University of Michigan authors write, "Although improvements in biochemical failure might be important, we must not forget that non-prostate cancer deaths remain the dominant mode of death, and treatments can worsen other-cause mortality. For example, the addition of hormone therapy to salvage radiotherapy in patients with PSA less than 1.5 increased other-cause mortality and cardiac events. Thus, the poor correlation of biochemical failure-free survival with overall survival might also be due to treatment intensification resulting in worsened other-cause mortality without greater improvements in prostate cancer-specific mortality." Of course, every case is different. But the point the authors were making is that treatments like ADT take a toll of their own. I recommend reading that medical journal article in its entirety. You'll find it at the link that I provided.
Replies to "I have similar concerns. In the following medical journal article (https://pmc.ncbi.nlm.nih.gov/articles/PMC10949134/), the University of Michigan authors..."
I actually read this article when I first knew I would need salvage radiation. I consulted with an RO who totally agreed with the article, telling me that any PSA less than .7 did not need ADT, only radiation.
I then consulted with Sloan and they said I DID need ADT, which had been my feeling, in spite of the newer findings. I asked my urologist what he thought and he said that although the newer findings supported the idea of no ADT, 6 months on Orgovyx in an otherwise healthy or medically supervised patient “couldn’t hurt”.
My feeling was that my Gleason 4+3 unfavorable just might be a bit more aggressive than “Intermediate” might imply and even though my surgical pathology was negative, it STILL recurred. So I wanted to hit it as hard as I could so hopefully I could end this problem once and for all🤞
Connect
Just finished ( reading ) - highly relevant and thank you. For instance, my main 'risque associée' would be hypertension ( Fr ) or raised ( but controlled ) blood pressure. I would not want issues with that. At the same time, as an amateur jazz musician, I have always benefitted from a semi-photographic memory and would not want to give that away in return for seemingly minimal yet unquantified benefits. If I di accept 90 days of HT I am wondering if side effects are pro-rata reduced?
David