Intermediate-Risk: Do You Need Hormone Therapy With Radiation + 80yrs.

I think there are lots of different kinds of "over 70" and "over 80," so it would depend a lot on the person.

Some people in their 80s are more active and engaged with the world than others 20–30 years younger, and a few extra years might seem well worth fighting for; others might already be tired from fighting other health conditions for a long time, and elect to be made comfortable to get the most out of the time they have left instead.

They're both reasonable choices, and no one else has the right to make them for you.

Indeed so, completely agree, but given that muscle mass and bone matter loss, together with an ever present increasing risk of cognitive issues will increase at 80+ for most folks there seems to be no point in exacerbating the situation - few seem to completely escape the worst side effects of ADT. Have you looked at the two links to papers/studies I linked/citing the debatable gain of RT + HT/ADT as opposed to RT alone - especially for those over 70/80 and the more so in light of recent improvements/refinements in radiation technology? Worth a look.

I’ve watched quite a few of his videos and I like him. But many times he poses rhetorical questions about treatment more than he gives definitive answers. Good questions, to be sure, but not the cold, hard facts I look for.
My own feeling as a layman aged 70, now in my 6th and final month of Orgovyx, is that it is a GREAT drug for PCa - especially for Intermediate Grade. I never had a Decipher score, but if I was at .45 or more I would have insisted on it.
As my urologic surgeon told me, “6 months of ADT isn’t gonna kill you”.

But it may not be quite as necessary as it was in the days when radiation was less well developed and ADT was brand new on the scene?? Depends on the specific case of course. A doubling up of side effects 5 RT + HT/ADT ) is what concerns me. Have you seen Dr Scholz's video dealing with :
'Radiation Therapy: Long Term & Short Term Side Effects' on YT?

When asked point blank regarding ADT with my Salvage Radiation, my RO said that "taking ADT would only give me a 3-5% chance of a better outcome than the radiation alone."

(post RP, lab said "Radical Prostatectomy - Pathology report Perineural invasion, and Lymphovascular invasion Stage pT2c, pNO.")
PSA had gone up to 0.091 from a low of 0.039
PET was Negative results for metastasis, but, it seemed there must be something growing somewhere...

He's a younger guy and seems to be up on the current stats and treatment. (it's a little annoying that he answer every question with a stat...LOL), but, I was really comfortable with him. A lot of folks I talked to thought the ADT was probably overkill.

My response was "give me all ya got doc!"

I'm off it (Orgovyx) after two years worth and for the last 6 mos my PSA has been < 0.006. So in my feeble brain, worth it. If/when it starts up again down the road somewhere, at least I'll feel like I did everything I could.

Now, do you "NEED" it at 70/80? I agree with most of the other answers, it depends on your general health and more importantly, what are you comfortable with.
Best of luck to you!

I think that's an entirely reasonable decision.

It's also important to remember that the docs are necessarily working with studies written 5+ years ago based on data from 10–20 years ago, so while they're the best information they have to offer us (besides anecdotes from their relatively small sample of personal experience), those stats may not fully apply to modern medications and treatment strategies.

The second thing to remember is that many studies measure overall survival, not specifically death from cancer. Sadly, once people are over 80, there's an elevated chance of dying from *something* in the next few years even if it's not cancer.

So if you're over 80 and being treated for early-stage cancer, a 3–5% improvement in overall survival could (in my untrained layperson's opinion) represent a much larger improvement in your odds of not dying specifically of prostate cancer.

Your mileage may vary.

Really helpful perspective for a 'neubie' like me awaiting to hear treatment proposals on Tuesday from my French urologist. In the end, an actuarial view is all we can take.

Bonne chance!

David

Back in my year 1 aPC phase I was in lots of pain, depressed, anxiety issues, I wanted out. Took about a year for my mind and body to learn to deal with PC + Treatment Side Effects. That was five years ago. Now I want to keep this show going long as I can. What changed? My Mindset. I've constructed a positive Quality Of Life mindset that wants to keep going. I am now 71 and hoping for 72. 80 is a big ask, it's not the number, its the joy and gratitude of living today. Much joy.

where are the two links? My cognitive function declined. I am certainly over 80!

Sorry Zooblio6:
when you say the two links, You meant the you Tube video's of Dr Schulz?