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Who prescribes ADT?
I’m working with Cleveland clinic and went to Mayo Jax last week to start the 2nd opinion process. I’m working on getting all my scans to Mayo. In the meantime I met with the surgeon at CC. He recommended ADT and then surgery. That’s all I have so far. I’m meeting the CC oncologist on Tues and their radiation oncologist on 3/7th. I’m wondering who will get me started on treatment. I’m 61, gleason9, clean scans( mri, bone, PSMA). Once I get feedback from Mayo I can decide on next step. I’m leaning towards surgery since surgeon felt he could get good margins. I’m very fit and exercise daily. Walked 5 miles today, gym several sessions per week, lots of golf very active. Thank you for your insights. You all have been fantastic!
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TM91, I'd ask the surgeon who recommended ADT to prescribe Orgovyx. Once you've take it, you've started treatment. And you can take the two months to make the final decision. A urologist or oncologist can prescribe with the best and fastest chance of approval.
Surgery may be best for you but be sure and check out MRI guided radiation before you decide.
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1 ReactionUrologists are the surgeons when it comes to prostate cancer. You could ask that doctor at the Tuesday meeting if he could start you on ADT, or ask the urologist who recommended it.
Surgery at 61 would bring with it the inability to have an erection, unless they can spare the nerves, And even then, there are issues. Radiation has been just as effective as surgery and you usually don’t lose the ability to get an erection. Ask the surgeon if he can do nerve sparing surgery.
Of course with a Gleason nine getting surgery first still leaves radiation open as an option if it comes back. Maybe you could get a decipher score to see how aggressive your cancer is and how likely it is to come back. I was just hearing from a person last week who was a Gleason nine and had his surgery in 30 years ago. You just never know with prostate cancer.
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3 Reactions@jeffmarc @gently thank you both. You’ve been immensely helpful. I’m hoping that surgery is the option. I know there will be consequences but I like the idea. I will certainly research all the radiation options as well. I’m going to get opinions from Cleveland, MayoJax, and probably another. Miller in Miami or Dana Farber. I live in south Florida.
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1 ReactionI m a novice here, but based on your age it’s gonna be a prostate ectomy. No metastises
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1 ReactionI am G9 CR locally advanced PC etc My surgeon recommended ADT and Erleada for 6 months before and after surgery because that made the tumor smaller and gave a better chance of getting it all. That was 40 months ago and I am still undetectable PSA. I am thankful for that guidance and thankful that I took it Select excellent physicians and be a good listener I am 78 and hoping for as much time and quality as possible This is very serious stuff. Good luck!
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2 Reactions@hbp thats great information. I’m glad you are doing well. I’m hoping for the same. Thank you
@tmestanas91
Have none of your doctors mentioned Decipher test? It is a more prescise test to determine the risk level of your specific cancer. With that test would give you a more prescise information on treatments.
ADT is a hormone treatment along with many others. Hormone treatments don't kill cancer. What they do is starve the cancer cells the hormones they feed on. Thus is stunts the cancer growth and provides a level for surgery or radiation to work without the cancer growing unrestricted.
Treatments are just a person decision thing. Do a lot of research on both radiation and surgery. What you chose should be what you want to endure for the treatment of your cancer. Both have very good outcomes when prostate cancer is still inside prostate. But having the Decipher test will determine whether it is low risk, intermediate, or high risk. With that information can really help you and your urologist and/or R/O decide with you on the best treatments for you.
I went with SBRT and my RO prescribed it
They keep telling me with Gleason 9 the decipher won’t matter.. I’ll push back @jc76 . Thank you for your insights.
Sounds like you’re in good physical shape. If you decide to get ADT you may loose your shape. Myself, I’m in good shape and an avid runner. I still am after my surgery. I’m grateful.