I am 83 years old, Gleason score 4 + 3, PSA 20.1. The seminal vessel is also affected. Mayo recommended both IMRT and 6 months of ADT. Lewis Cancer center in Savannah (where I live) had the same recommendations. Mayo said I could eliminate the ADT but the long term results would not be as effective if I eliminated the ADT. As of this date, the effects of the ADT have not been too bad...a few night sweats and tired in the afternoon. I still work out every morning and believe this has really helped with minimizing the bad effects. Good luck to you .