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← Return to Onward with durable remission
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Hi
Gleason 9
Decipher 0.99
RP followed with persistent PSA then SR and 6 months Lupron. 2 weeks later PSA undetectable and T=4.
My health provider wants me to do a total of 18 mos ADT ( ie 12 mos more). Got a second opinion from a “center of excellence “ and they said 6 mos( ie no more). It’s a tough one for a guy on the street to make this decision. My reading says that the benefits of long ADT is constantly described as a grey area but the systemic side effects of long ADT are well documented. On that basis I have opted for the 6 mos (which I have completed) with a monthly PSA/T/blood panel test from hereon to catch anything if it twitches. Then I will be open to going back on ADT. So maybe I will be on Intermittent ADT which has been described in studies as “non-inferior” . The other murkier are I have read about is the selection pressure that intense ADT can put on the PC cells pushing them towards castrate resistance. So maybe intermittent ADT might be helpful? Being new to the PC club ie everything has happened this year I am a bit shocked at all the grey areas and highland mists that surround this particular cancer….
Des
Replies to "Hi Gleason 9 Decipher 0.99 RP followed with persistent PSA then SR and 6 months Lupron...."
It's a new year and I'm in a funk, I'm 77 had chemotherapy 18 months ago then ADT for a year my PSA is undetectable .01 and have been taken off my luperon now for 4 months won't see the doc for another 2 months. I've talked to several RO'S with the same advise PSA undetectable let it be, never had any side effects from any treatment except fatigue and that's the rub on me. I've always been active living in Utah did a lot of back country with my dog's. Sorry for the run on I'm just happy to still be here.
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I would try to decide which provider to trust and follow the recommendation. I took Orgovyx for 4 mos.
Very challenging issue; after 2 yrs of receiving treatment and reading, I still have not seen a definitive treatment protocol. And, I believe that is due to the variability of each of our "input info", actual treatment received and provider experience.
RP at 72; postop path confirmed G 9 w/ EPE, all else clear; 90 day persistent PSA at .19; Salvage Radiation Treatment to WPRT and pelvic lymph nodes w/ 4 mos ADT.
6 mo PSA after completing radiation and 4 subsequent uPSA quarterly results all thankfully "undetectable".
My Rad Onc at COE recommended 4 mos of ADT. 2 other treatment friends received 6 mos ADT (each had different Rad Onc at same COE). Not sure about their Gleason scores; may have been 7s.
Personally, I would look to the uPSA test 6 mos from end of radiation treatment (or ADT completion) as my "lighthouse". And test quarterly thereafter.
Best wishes; this is not easy.