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Weighing the cancer risk reduction & quality-of-life cost of ADT?
Prostate Cancer | Last Active: Feb 13 5:00pm | Replies (123)Comment receiving replies
I agree and I never stated that Dr. Kishan is opposed to ADT. On the contraty I stated in my earlier response, that Dr Kishan is a very strong advocate of ADT. My question and concern is about his other statement that 1 out 8.4 high risk patients who are treated with ADT get the cancer cure and life prolongation beneift of ADT. He also said an NNT number in this range (1 ouf of 10) is a good number in medicine. That is what is puzzling me since to me, this means - on the average - 7 out of 8 high risk patients like me who get ADT get NO real benefit from ADT while they are 100% guaranteed to get side effects which could be mild or serious. That is what I am wrestling with since quality of life is very important to me. I will see what he says about my question and concern.
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@soli
I just want to add that all those statistics are just that - numbers and averages , and how will each patient react or what the result will be is very individual. There are absolutely no guaranties. I even stumbled on a study that mentioned as a "side note" that average lifespan after RP for patents who "did nothing" is 13 years ! It really makes you think ... Also, most studies concentrate on "time to BCR" while OS (OVERALL survival) is at the end almost the same - one just gets treatments sooner or later it seems but results are very, very close in "years" lived in total. Graph for example can show 25% better result but translated in real numbers it is 25% of 8 % which is actually 2 % !!! So yes, 25% of patients had somewhat longer life span but only 8% died in total in the whole cohort in that span , so, it made a difference for just 2% of patients and not much in total number of years. I am talking here in general terms, this study was not about ADT - I am just saying that one needs to read results and studies in detail and try to see the whole picture and what certain "%" means "in real life."
I did not have time to watch this video but isn't this video about initial therapy ? Not about adjuvant ? I am sure that there must be a difference of how is treatment performed and what is included in it and what type of radiation. I do not think that SBRT is first choice for adjuvant ? I might be wrong, but as far as I read and what our RO suggested is IMRT plus 6 mos of ADT.
My personal view about ADT is that it is overall less harmful that radiation, and especially if it is just for 4-6 mos. One can always stop using it if side effects are just intolerable and some people have really minimal side effects with it.