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← Return to Numbers After SRT/ADT
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Chippy and Jeff, the newer ‘guidelines’ say that men with rising PSA after surgery, whose PSA IS LESS THAN 0.7 should not get ADT. This is based on a large retrospective study which found that the harm is greater than the good.
However, I disagreed with this when diagnosed by my first RO since I felt that my surgical pathology of Gleason 4+3 Unfavorable made it more aggressive.
So I got a second opinion from Sloan and they agreed that, study or no study, they were using ADT. So I am sure plenty of Uro’s are saying that overtreatment is being rendered in many cases since we all usually go running for SRT at 0.2. Best,
Phil
Replies to "Chippy and Jeff, the newer ‘guidelines’ say that men with rising PSA after surgery, whose PSA..."
Interesting point of view. Fact is, If you have a problem, your PSA is gonna hit .7 pretty quickly. I know for me, just cutting back Zytiga from four pills to three caused my PSA to rise from .2 to 1 in 18 days. I went right back on four pills. Another example, in 2017 I got my six month Lupron shot late by two weeks, Same day I had a PSA test, My PSA had risen from undetectable to .6 that month, I was undetectable for the next two years. If you have a problem, it can go up quickly. I was a Gleason 4+3.
Have to admit It’s a good idea and must be backed up by a lot of data. According to AUANews however exceptions include “Other high-risk features include grade groups 4-5, PSA doubling time (PSADT) ≤ 6 months, persistently detectable postoperative PSA, and/or seminal vesicle involvement.”
The kicker for me is seminal vesicle involvement. Where we thought it was a problem, but to include that in exceptions, but not cribriform is interesting, and a little scary for some.
If they’re not waiting for .7 they are over treating a lot of people. I know that up till now that .7 has not been the rule. But I suspect there’s a good number of doctors that didn’t do ADT after surgery if it was just a Gleason seven. That’s what happened to me, though that was a long time ago.
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Phil - are you saying you wish you had ADT immediately after surgery regardless of PSA or as soon as PSA went to 0.2 ? Sorry to interrupt this thread , I am now trying to learn about salvage treatments since with our luck and cribriform it is high probability that my husband will need it.