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How long does your oncologist have you on ADT?
Prostate Cancer | Last Active: Sep 28 12:11pm | Replies (69)Comment receiving replies
For those of us who are stage 4 metastatic - forever. Even if, and I emphasis if you become castrate hormone resistant most doctors have you continue on your ADT shot and ARSI medications. Why? Because it is because these medication are still working on the cells that are not resistant. I said if to castrate resistance because not everyone become resistant. It is just not true that it is a matter of when. I do not know the percentage of men that remain castrate sensitive but men with stage 4 metastatic do remain castrate sensitive throughout their disease journey. This is why I believed in hitting the cancer as hard as possible upon being diagnosed. Radiation to the spin and ribs - keeps killing cancer cells 2+ years. 10 cycles of docetaxel chemotherapy. It took 33 weeks to finish chemo. That is a a lot of cellular death and DNA cell damage to the cancer cells. Cancer cells do die. They just do not die in the normal timely fashion. Cancer is killed in three ways - radiation, chemo, and starvation through ADT, ARSI's, and diet.
Replies to "For those of us who are stage 4 metastatic - forever. Even if, and I emphasis..."
That's a good point. As far as I understand, the reason castrate resistance sometimes emerges on ADT is that the castrate-resistant cells (if any) are the only ones that can multiply, so eventually they reach a point that's detectable.
If you weren't on ADT, both the castrate-sensitive *and* castrate-resistant cells would be multiplying, so you'd have more cancer sooner, possibly in vital organs.
ADT buys you time, even if castrate resistance does eventually emerge. You're forcing the cancer to restart from a much lower point.
Actually, you become castrate resistant and ADT no longer keeps your PSA down, Even though you are castrate resistant, not every cell is castrate resistant as you mentioned.
You then begin an ARSI Because they are capable of keeping the PSA down, even if castrate resistant.
I’ve been castrate resistant for six years, If I reduce my main ARSI drug, my PSA rises immediately. I was on Zytiga for 2 1/2 years. I tried reducing from four pills to three to see if it would help with the brain fog. My PSA went from .2 to 1 in 18 days because I had reduced the ARSI.
I stopped taking Orgovyx For eight months. Darolutamide Kept my PSA undetectable the whole time. That’s because Darolutamide works even if there is testosterone. (Other lutamides too).
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I agree--forever. My husband has been Stage 4 and castrate resistant for many years, and has stayed on Lupron the entire time. His local medical oncologist and the Pluvicto team and the Kwon team at Mayo all agree that it makes no sense to remove one of the weapons you are using to fight the cancer.