Has anyone gone off hormone therapy (ADT) after radiation?

Posted by gkgdawg @gkgdawg, Sep 2 11:42am

My husband has completed 5 weeks of radiation and 4 months of hormone therapy, 3.5 months ADT. His PSA is less than .2 The doctor seems pleased with the PSA and is hoping that it will soon be undetectable. If he gets to that point, can he take a break from hormone therapy and ADT. He gets his next hormone shot in October. I am hoping he will get Orgovyx , instead of the Elegard. I hate that the hormone therapy has impacted his muscle and bone density. He looks smaller to me. He is trying to do weights and he is signed up for a weight room next month, when we return home from our summer holiday. I would appreciate any input

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Profile picture for gkgdawg @gkgdawg

Thank you for the caution, Jeff. Absolutely, any changes would have to be done with caution and medical advice

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I forgot to mention that my Gleason score was 4+3, Not considered real high.

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Profile picture for jeff Marchi @jeffmarc

I forgot to mention that my Gleason score was 4+3, Not considered real high.

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Yes, that is the same Gleason score that my husband had. I am just wondering if that ever changes. That was his score when they did the biopsy, However, with the delay in treatment, the PSA want up in the following months. Wouldn't that impact the Gleason score?

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Profile picture for gkgdawg @gkgdawg

Yes, that is the same Gleason score that my husband had. I am just wondering if that ever changes. That was his score when they did the biopsy, However, with the delay in treatment, the PSA want up in the following months. Wouldn't that impact the Gleason score?

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According to literature I have read the Gleason score doesn’t change on the cells that are already examined. If you let the cancer continue to grow the Gleason score on new cells can be higher. And to even make it more complex when they do a biopsy, they only got about 1% of the tissue, so there could be higher This is just about Bill score cells already there.

If you have a prostatectomy, you can find out what the actual Gleason score is. In my case, after the biopsy, it was 3+4, After the prostatectomy, it was 4+3.

I know people that had 3+4 after biopsy and had Gleason nine after prostatectomy. The results really vary a lot.

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Profile picture for jimgaudette @jimgaudette

After three years on ADT, I have been off for eleven months. There has been no improvement in the side effects (which are many and awful) My testosterone is now up to 100 (from < 4) and I am hopeful that the side effects will decrease as the testosterone improves. I am 74 years old, walk 3-5 miles per day and do intense yoga and weights three days a week. In addition to calcium with D3, I take Alendronate for my bones. Luckily, my PSA has remained “undetectable”.

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Hi Jim. What dosage of calcium and vitamin D do you take? My husband just started on ADT and I’m in heavy research mode. Thanks.

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Profile picture for ucla2025 @ucla2025

Hi Jim. What dosage of calcium and vitamin D do you take? My husband just started on ADT and I’m in heavy research mode. Thanks.

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I take 600 mg calcium and 60mcg D3 twice daily (morning and evening) and 25 mg iron every afternoon. I take one 70mg Alendronate tablet weekly. I also exercise one hour daily, eat healthy and don’t drink alcohol. ADT often causes muscle, bone and red blood cell loss as well as high blood pressure and high blood sugar, so these need to be monitored and addressed. He can expect hot flashes, frequent crying, depression and all the symptoms of menopause. If he experiences ED without a loss of libido, I can address that if you ask me. Your understanding and support are essential, as he will need them.

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Profile picture for ucla2025 @ucla2025

Hi Jim. What dosage of calcium and vitamin D do you take? My husband just started on ADT and I’m in heavy research mode. Thanks.

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The side effects of ADT are cumulative and generally get worse with time. The good news is that ADT usually stops the growth and spread of the cancer and will help keep your husband alive.

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Profile picture for ucla2025 @ucla2025

Hi Jim. What dosage of calcium and vitamin D do you take? My husband just started on ADT and I’m in heavy research mode. Thanks.

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I have a pharmacist from my medical team call me every six months To go over my drugs and any complications they could cause.

First thing they told me was make sure to take calcium citrate not the calcium carbonate I was taking. It is much better absorbed by the system, even without food than other types of calcium. Your body will only use 500 mg of calcium at a time, If you take more at one time it will just be discarded by your body.

I have to take 500 mg of calcium three times a day because my calcium tends to be quite low. ADT really chews up your bones if you don’t take calcium and another bone strengthener.

Costco sells Calcium citrate with vitamin D and magnesium, two things that are really helpful when you’re on ADT drugs.

My oncologist has never recommended I take iron. It does have some real problems with having either diarrhea or constipation so you might want to check your iron levels before considering taking it. They call that iron test the ferritin test.

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Profile picture for jimgaudette @jimgaudette

The side effects of ADT are cumulative and generally get worse with time. The good news is that ADT usually stops the growth and spread of the cancer and will help keep your husband alive.

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Thanks so much for your thoughtful responses. They are very helpful.

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Profile picture for jeff Marchi @jeffmarc

I have a pharmacist from my medical team call me every six months To go over my drugs and any complications they could cause.

First thing they told me was make sure to take calcium citrate not the calcium carbonate I was taking. It is much better absorbed by the system, even without food than other types of calcium. Your body will only use 500 mg of calcium at a time, If you take more at one time it will just be discarded by your body.

I have to take 500 mg of calcium three times a day because my calcium tends to be quite low. ADT really chews up your bones if you don’t take calcium and another bone strengthener.

Costco sells Calcium citrate with vitamin D and magnesium, two things that are really helpful when you’re on ADT drugs.

My oncologist has never recommended I take iron. It does have some real problems with having either diarrhea or constipation so you might want to check your iron levels before considering taking it. They call that iron test the ferritin test.

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Thank you, very helpful. Even though the topic isn’t all that great I appreciate all the helpful information I learn from you brave gentlemen.

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Even just three weeks of physical inactivity can trigger a noticeable muscle loss in someone who's on hormone therapy. You've got to maintain weight training (and cardio, for overall health) THROUGHOUT the period when you're on hormone therapy. For someone who hasn't been previously physically active, it's imperative to begin exercising at the same time you start on hormone therapy. Sooner is even better.

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