ADT with EBRT and Brachytherapy

True statement agree

My thoughts; each of us react differently to the cancer within our bodies. I was diagnosed at age 57 and had HDR break Therapy and ADT therapy continuous. I have had some chemo and lots of different pills and changed my diet. I am currently undergoing Pluvicto treatments., which is what I would recommend. If Medicare doesn’t cover them hopefully your insurance will pick up part of the tab. Each treatment and there are six and the program is approximately $44,000. One treatment every six weeks.
It reduced my pain levels by more than half and I was only nauseous and sick for the first three or four days and then I started feeling good enough to resume living my life. It did not cure me nor did it bring my PSA down but I do feel better and I look forward to some radiation on an Aggressive spot of cancer on my vertebrae. My PSA is 377 and going up about one point per day, which is my greatest concern and also something I cannot get answered from any of my doctors.
Radiation has been the best and effective treatment for the bone cancer, which followed the prostate cancer chemotherapy was mostly just money for the hospital and illness for me. I’m not sure at the most effective path to cure this; but that is something I surely wish I knew.

If your PSA continues to climb perhaps you have become castrate resistant? Perhaps genetic testing may be in order as well? Best,
Phil

To summarize, it’s your way or the highway- to H__ with protocol. Have at it. I know I m not as smart as researchers so I follows proven plans of treatment. I m not an Ivermectin junkie . I hope your not either. Take care and keep us informed with your experimentations.

I appreciate your response, but I think you may have missed the point of the discussion. It’s not about rejecting protocol or claiming to be smarter than researchers—it’s about recognizing that protocols evolve, and patient-specific factors sometimes call for individualized approaches within or alongside evidence-based frameworks.

No one mentioned Ivermectin or conspiracy theories here. I’m simply advocating for thoughtful, informed choices—not blind adherence or reckless experimentation or established dogma that serves most, but not all. If one is part of the "not all" crowd, then dogma might not be right, or might accelerate progress. . That said, I do appreciate the exchange, and I’ll definitely keep sharing updates. Take care.

I totally understand your thoughts and I can see how you might feel that a different course of action is appropriate in your case. But I have to ask again:
WHAT exactly do you think should be done? No ADT?
Supplemental T? No treatment?
You believe that since your T is inherently low, your cancer must have already become castrate resistant and ADT is starving it of nothing, since it never depended on T to begin with…correct so far?
IF that is the case, how on earth could anyone know this UNLESS they first applied the “gold standard” and saw that it failed…right? Doctors cannot simply hypothesize without any evidence whatsoever that your cancer is different from the thousands they’ve treated. IT MIGHT BE - but they need evidence of that since in North America we practice evidence based medicine.
How would you feel months from now if you learned that your doctor completely deviated from accepted practices and instituted therapy and treatment that was detrimental and possibly lethal? WTF, right?
So, Your radiation treatment is half over; once it’s done it will be many months before you know if it was totally successful because you’ll still be on ADT and many times PSA fluctuates and goes higher before dropping to the nadir; this is NOT failure of treatment.
IF - after the ADT is out of your system and you’ve reached the nadir - your PSA starts to rise, then PERHAPS your theory might be valid OR more likely, you are one of those individuals who can never be off ADT.
I don’t know if you’ve had any of the genetic testing that @jeffmarc suggests, but those results would certainly prove beneficial should the “gold standard” fail and it is determined that genetic factors are making your cancer unresponsive to treatment. Best,
Phil

I wondered if the prostatecancerpromise test is the same as a Decipher test? My oncologists (Hartford Hospital - Tallwood Mens Hospital) has ordered a Decipher (results pending). Thank you.

There is no relationship between a decipher test and a hereditary, genetic test. They look for completely different things.

Thank you, Jeff (again)!

Statements such as "no improvement in overall survival" when applied to comparisons of treatments that include brachytherapy (BT) and treatments that don't, need to be looked at more closely. Proponents of BT point out that over the long term, less salvage therapy is required with many of the treatments that include BT. This affects quality of life considerably. A BT treatment that required less duration on ADT and less possibility of salvage therapy because of recurrence, could be said to have "no improvement in overall survival" compared to other therapies, but if the long term survival attributed to those other therapies includes years of ADT and higher possibility of salvage therapies, many patients would choose the treatment plans that include BT.

There seem to be many ways to compare treatments in the literature. Patients are expected to understand that comparisons may not be as meaningful for factors they are concerned about, such as quality of life or the burden of treatment and/or salvage treatments, and it is a lot to know.