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Gleason 9 SO wants me to stop ADT @6 Mos for look see

Prostate Cancer | Last Active: Jun 11 11:11am | Replies (32)

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@northoftheborder

I'm over 3½ years into ADT and Apalutamide. I'm not stopping until there's a credible body of evidence that it's safe to take a hormone-therapy holiday with advanced PCa (there's not), or until it's causing side-effects that are a bigger risk than the cancer itself (it isn't).

As @jeffmarc hinted, having undetectable PSA this long is a huge piece of luck, and I have no intention of rolling the dice and maybe having it come back castrate-resistant.

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Replies to "I'm over 3½ years into ADT and Apalutamide. I'm not stopping until there's a credible body..."

I am stage 4 and also have the BRCA 2 gene mutation. On ADT for 7 months now ( Trelstar and Darolutamide). Current PSA is less than 0.10, my tumor and metastatic areas have greatly diminished, no more symptoms at this point. I asked my doc about an ADT holiday and he said no and instead wants to keep me on ADT for at least 3 more years. He told be highly mutated cancers like mine, (G9) are very dangerous and will eventually mutate again, stopping ADT will only open a window to let it mutate into something worse and less treatable. I am managing ADT side effects well, so I plan to stay on ADT as long as it continues working.

I'm just 2-1/2 months into Orgovyx, starting 2 weeks before my SBRT. My RO indicated that maybe I can stop Orgovyx after 8 months or a year.
I was unfavorable intermediate at time of diagnosis, PSA 10.6, Gleason 7 (3+4) on 3 of 14 cores.
My first PSA test post-SBRT is July 8, seeing my RO on July 15. I plan on stopping ADT after 6 months, instead of 8 months or more.
Will you consider my plan as like "rolling the dice" too soon? So far, I have almost no side effects from Orgovyx.