@ksellers3

Determining if a treatment worked or did not for me is a function of the outcomes I was seeking in choosing a particular treatment.

The two that didn't work:

Surgery. The outcome was to be "cured." I knew the risks, incontinence, erectile dysfunction and the litany of risks associated with surgery. Still, I wanted to be "one and done...!

When the surgeon went over the pathology report with me, he was practically gushing with its "success" based on the pathology report and his observations and surgical notes. Keep in mind, he had done quite a few so had a basis from which to say so. Still. I asked myself, given the Mx, do they really know there's not distant metastases? The MSKCC nomogram said based on my clinical data there was a 30% chance I would experience BCR. 18 months later...failure.

SRT was the 2nd failure. The standard of care at the time was based on the theory that in patients with BCR the PCa cells travelled sequentially, starting with the prostate bed. Ergo, at the first sign of recurrence, not later than PSA of .3, radiate the prostate bed, it was a 2nd chance for the "golden ring, " a cure. Mayo had data that said this was not correct and ongoing clinical trials said in high risk patients the recurrence was already in the lymph nodes and treatment should radiate the prostate bed, WPLN and short term ADT. At my first jab and lab 90 days after SRT my PSA had jumped from .3 to .7, another thirty days it was 1.0, epic failure.

The next two treatments, triplet and doublet therapy o changed my outcome, knowing advanced PCa was not curable, my outcome was 3-5 years of progression free survival. That would enable time off treatment, recovery of T and advances brought about through medical research would provide more imaging and treatment choices.

My break from triplet therapy as I said was almost five years, outcome achieved. We're at 18 months now after doublet therapy so outcome not yet achieved but hey, it's been a good 18 months.

That's why I say when deciding on treatment discuss the outcome you are trying to accomplish with your medical team. As an example, those who wish to avoid ADT, is MDT in play?

Kevin
RCJH!