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My ADT Story, Feedback Appreciated

Prostate Cancer | Last Active: Jun 19 9:41am | Replies (34)

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They might want you to stop because while ADT can help hold off cancer progression, it increases your risk of diabetes, osteoporosis, and heart disease, and can also put a strain on your kidneys. In my case, with stage 4b to my bones, they figure that the cancer-progression risk outweighs the others (plus my bloodwork and other tests show that I'm tolerating Orgovyx and Erleada well as the end of year 4 gets nearer); in yours, they might figure that the immediate risk of progression is smaller, so it might be worth giving the rest of your body a little break.

While there are studies supporting ADT holidays for earlier-stage prostate cancer right now, it's still as much an art as a science trying to balance all those risks for each individual patient. I told my care team right at the start that I was all-in for fighting the cancer (age 56 then, previously fit and healthy except for mild hypertension), and they've respected that wish by "throwing the kitchen sink at it," as they described it.

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Replies to "They might want you to stop because while ADT can help hold off cancer progression, it..."

I was 69 when diagnosed (stage 4a). I turn 73 next week. I've had surgery, raditation and 2 1/2 years ADT with Orgovyx. I am type 2 diabetic, have high blood pressure, and reduced kidney function (latest eGFR was 44). I'm on medications for everything.

I am not the least bit concerned about the possible adverse effects of ADT. I'd rather deal with that if and when it develops. I'd rather take the path that is more likely to keep my PSA where it is now (< 0.01) and delay or prevent metastasis.

Yet, I don't think my Drs will allow me to go beyond 3 years ADT.

So, what's worse-- continuing ADT with it's possible complications or stopping ADT and risk cancer progression/metastasis? Continuing sounds like the less risky choice to me and maybe the ADT complications can be treated? This is the confusion and difficult decision I'm having. Of course, maybe the longer I'm on ADT the more likely CR will show up? And I've read that CR makes the prognosis poorer.