How long will Lupron work before prostate cancer becomes resistant?

I Don’t want to give the wrong idea, I’m willing to play the hand I’m dealt as long as I can. I’m just worried that for the next few years that im involved in non curative therapy I really should be looking elsewhere for an actual cure. We are all aware this type of therapy, ADT, is good medicine and should give me many years as my doc says, it still has an end. I’m 65 and want no less than 20 more years. How do I get it is the million dollar question!

I Don’t want to give the wrong idea, I’m willing to play the hand I’m dealt as long as I can. I’m just worried that for the next few years that im involved in non curative therapy I really should be looking elsewhere for an actual cure. We are all aware this type of therapy, ADT, is good medicine and should give me many years as my doc says, it still has an end. I’m 65 and want no less than 20 more years. How do I get it is the million dollar question!

My medical oncologist thinks there can e a cure. His first suggestion was surprising - SBRT, not Combination hormonal therapy. He said the hormonal therapy will only keep it at bay, but he wanted to go for the kill (possible cure) with radiation. Thirty six IBRT Radiation sessions gave me acute/chronic bleeding bladder, urinary retention, anemia, urethral obstruction, and incontinence. Now I have to get opinions in how effective, how accurate and how risky 3-5 sessions of this alleged pinpoint targeting SBRT really is.

Latest/best practice for metastatic cancer is to do both: a high dose of radiation to the prostate (and individual metastases if oligometastatic) to "go in for the kill", _and_ ADT + ARSI to keep down any individual cancer cells that the radiation missed. If polymetastatic, then toss in chemo, too. And they're currently researching introducing Pluvicto at an earlier stage as well (though it's still in trial for that, I think).

This is a big shift from just a few years ago, when they figured metastatic prostate cancer was incurable, so they'd try one treatment at a time, moving to the next when it failed, with the goal of keeping you alive and comfortable for your final couple of years. 🙁

Now the approach is more shock-and-awe: hit that f***er hard with everything they've got, all at once, with the goal of overwhelming it. It won't always work (yet), but at least we have a very reasonable hope now of long-term survival now, even at stage 4.

Thanks for the reply. I don’t think/don’t know if I’m considered metastatic.
- Post prostatectomy,
- post IMRT salvage radiation,
- post Lupron for 2 years.
PSA rose .014 to .53 in 21 months, so doubled a couple of times. Cancer activity suspected in right vas deferens only above bladder. Considering havoc radiation caused before, and that my bladder wall is thickened already, I’m reluctant to jump in without some strong opinion the radiation will not cause more major damage.

No, you're not metastatic (from that description). You might be a good candidate for an ADT holiday to give your body time to recover, especially if your onco is recommending it.