Prostate Hormone Shots: Why?

murpdil, did you have somatic testing? The tumor's mutation can give you an idea if the antiandrogen treatments would help. They've offered you the injection, but ask about Orgovyx. It is thought to be more effective and easier to recover from. I've been told that the best time for surgery or radiation is after two months of the medication. It can really shrink the tumor in addition to halting its progression.
There aren't guarantees, but not choosing treatment gives you no odds.
You may not be recommeded a life time of antiandrogen. It depends upon the stage. Your PSA isn't raging so six months might be recommended. Best wishes.

What was your Gleason score? Did you get a decipher score? What was your PSA prior to treatment?

What did the PSMA pet scan show? Any metastasis anywhere located by that?

My father died of prostate cancer. I remember the day he told me that Lupron, The hormone drug (equivalent) you would start with, Stopped working. His cancer just got worse and worse after that, and he died from it.

He didn’t have the availability of abiraterone or One of the lutamides to extend life. When Lupron stopped working for me I went on abiraterone, another hormone pill and got 2 more years.

What I’m getting at is that those hormone injections or pills extend your life If you have a high Gleason score, Above seven, you should be on one for sure based on the NCCN guidelines. You will have a better overall survival using hormones.

No metastasis: Gleason score is about an 8 x 2 seeing I'm on medication so it's a 16 roughly.

decipher score I'm not sure of.

A Gleason score is not doubled. If it’s eight it’s eight. It’s the PSA that is doubled because of the drugs you are on.

A Gleason score of eight means it is very aggressive. The NCCN says you should be on ADT for 18 months to try to prevent your cancer from reoccurring. That is what your doctor was getting at.

I was on ADT for eight years, I’m still alive because of it. I’ve stopped ADT because it’s unlikely my testosterone will come back after all that time, If it starts to come back, I have to go back on it. I am on a second drug, Darolutamide which is keeping my cancer at Bay. While ADT is not fun, it is something one can live with. If you have a problem, While on it come back here and we can help you.

There are micro metastasis that could possibly be in your body and they can’t be seen yet so your doctor won’t remove them. If you want the best chance of killing them all you have to start with hormone treatment.

Thank you, but I can't do that. The PSA doubled right.

I believe Finasteride is a mild ADT designed to treat benign prostate enlargement while still leaving a functional level of testosterone. It's likely that your PSA increased because of the cancer itself (which still had enough testosterone to feed it).

Taking stronger ADT designed specifically for prostate cancer, like Orgovyx (Relugolix), Lupron (Leuprolide), or Firmagon (Degarelix), will likely starve the cancer of testosterone and bring your PSA down to undetectable levels, at least for a while.

Best of luck!

In Dec 2024, you posted that surgery was an "unpleasant" prospect.
Your treatment alternative is radiation and you do not want ADT as part of the regimen.
And you want a "guaranty " that radiation treatment w/o ADT will resolve or "slow down " the process.

Therefore it seems that you can:
1 - find a RO who will radiate your prostate (by whichever means) w/o ADT.
2 - accept ADT as part of the radiation protocol, either short 4 - 6 mos or long 18 - 24.
3 - pivot back to RP and surgical removal.
Some things are pretty predictable: None of these options are guaranteed to cure you, and all of them will " slow down" the disease for some period of time.
4 - ADT only
5 - do nothing, because you don't want ADT.

What do you want to do?

None of us like the choices; all of us have had to choose.
Best wishes.

First of all, you assume you will be on hormones for life…why? That scenario is not at all guaranteed. You don’t stay on Penicillin for life after the strep throat is gone, do you? Look at ADT as medicine. A course of ADT for however long your RO feels is necessary, combined with radiation MAY cure you! But Nothing is guaranteed in life…
You have a Gleason 8 and even if you had a lower Decipher Score, a G8 is high grade aggressive cancer. Even cutting it out leaves the possibility that it could return, OK? So if you’ve chosen radiation - which is a good choice IMO - why tie your RO’s hands and not allow him to give you the best possible outcome?
I looked at my treatment like this: do everything possible to be cured - everything and anything; and if it doesn’t work I will never have to live with the regret of not having done all I could.
To me, failure to plan is a plan to fail, and without ADT you may be doing just that.

The number for your PSA is doubled because of the drugs you are on.

You say you can’t do that, I suppose you mean, can’t do hormone therapy.

Dying from prostate cancer is extremely painful, My father died from it and the last few couple of weeks he was on so much morphine for the pain he couldn’t carry a conversation. When I was a teenager, he had all of his molars ground down and crowned without Novacaine. He came home for dinner and ate after that procedure. Wouldn’t catch me doing that without Novacaine, he had a very high pain tolerance, not high enough for prostate cancer.

The fact is you can do it, you don’t want to do it. Your cancer will undoubtedly come back. Your life will be much shorter without it, Is it really worth it?

If it helps, restricting testosterone is a common treatment to slow or prevent mail pattern baldness as well as prostate-cancer progression (though they don't fully block it in that case), so there might even be a very tiny silver lining to being on ADT. For me, no longer having almost enough hair on my back to shampoo has also been a small bonus, though I do miss the hair on my chest.