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← Return to Gleason 7 (4+3) radiation, but ADT also? Over treatment?
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Gleason 7 (4+3) radiation, but ADT also? Over treatment?
Prostate Cancer | Last Active: 5 days ago | Replies (78)Comment receiving replies
I just turned 77, Gleason 4+3, always PSA < 1, Grade 3, T2a; However I have a mixed morphology of acinar and the more aggressive ductal. No spread to the bones or organs as indicated by CT scans. bone scan and PSMA pending. I also have read that ADT may represent overtreatment in older patients.
I am otherwise in near excellent health. Wondering what to do about ADT?
Replies to "I just turned 77, Gleason 4+3, always PSA < 1, Grade 3, T2a; However I have..."
Ductal IS considered more aggressive, as you point out, so IMO it needs a bit more in terms of treatment.
After your PSMA, options are surgery or radiation; and ADT would be recommended with RT because of those more aggressive cells. Also, a ‘brachy boost’ of high intensity seeds could be placed in the more serious glandular areas to hit those cells the hardest.
If you opt for surgery it’s a more ‘one shot’ type of thing but there are MANY dide effects
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Six months of ADT for a 4+3 is no big deal. I was on it for eight years and over time. It really hasn’t been that much of a problem. I do walk on a track twice a day for about a mile each time. I never did feel much fatigue from ADT, not everybody does. Yes, I got a lot of hot flashes at the beginning, but there are solutions to hot flashes. You do need to take something for a bone health if you are on it for more than six months.
After prostatectomy, my PSA was 4+3. I didn’t have ADT and it reoccurred 3 1/2 years later. I had salvage radiation and it lasted 2 1/2 years before I had a reoccurrence. If I had been on ADT, maybe I would not have had the reoccurrences.