ADT, maybe not? Anyone opted out of ADT?

I'm happy to report that my husband doesn't have prostate cancer. My father-in-law did however so he monitors closely.

@wwsmith, such a hopeful and encouraging response about the success of your treatment. Your experience will be helpful to others in the forum with a similar diagnosis. Glad to have you here.

I don’t know very much about ADT other than hot flashes, depression and possibly breast becoming larger. I hear a lot of men complaining. However, I’ve also heard from others on this site that it’s not that bad. I know this though more men make a choice to go with it than not. I’m looking at the same situation in a few months, I don’t want it but my family means everything to me. I intend to take ADT if I have to and I guess if it’s where I find it impossible to handle I stop it. But at least I tried. Just remember you’re the only not one that can make that decision. God Bless

I have a comment on this a year or two previously. Had 29 proton sessions 3 1/2 years ago. ADT was strongly advised by RO but declined by me. 4+3 with no spread with PSA of 9. Now 78 years old with last PSA of .32. Decipher test was .51.

@madpuppy74

You are absolutely right. Lupron is likely to destroy your libido. I have read that less than half of the men recover their testosterone after Lupron treatments. Duke Health has published research that says low testosterone actually helps aggressive cancer grow. My urologist is not ready to accept these results, but you wonder who is right. see: https://corporate.dukehealth.org/news/study-solves-testosterones-paradoxical-effects-prostate-cancer

@pesquallie
Doctor Sartor Discuss BAT in this article
https://online.flippingbook.com/view/150884930/4-5/
If someone has Zytiga or a lutamide Stop working BAT can be used to resensitize the person back so The drug can again work.

It doesn’t work in all cases, but it does work for some patients.

It could also confuse the cancer and cause the more aggressive cells to start dying.

I was really against ADT along with radiation when my cancer came back 5 years after RP. But some research , and my brother, talked me into it. The odds of non-recurrence go way up when you go the ADT route. Also, if there is recurrence, I'd be on ADT for the rest of my life. So I did 6 months of ORGOVYX which ended OCt. 1. There is no doubt, the side effects of ADT are not trivial. But! Manageable. I was especially diligent about sticking to an exercise protocol which included resistance training.,which really helped . and I took a half hour nap every afternoon- a benefit of retirement. Bottom line: I am glad I bit the bullet and did it.

The choices are yours. It is your body. I had SBRT radiation a year ago. PSA was 6+ and Gleason score was 3+4. Nothing beyond the prostate. Urologist put me on Orgovyx which I took for 3 and a half months. The radiation oncologist said he wasn't sure he would have put be on it. Just before my last SBRT session, I received a call from the urologist about an appointment for another 3 months of Orgovyx. I declined the additional 3 months. The radiologist said to just finish what I had. Currently, PSA is undetectable and testosterone is 163.

@crusader76 Glad to hear about the outcome of your treatment. I just finished IMRT for a local recurrence (no evidence of mets on PSMA PET scan). My PSA was only 0.11 (had been undetectable for ten years following RARP), but I also have a palpable nodule in the prostate bed that lit up on the PET scan. I declined ADT because I concluded that the benefits did not outweigh the risks in my case. I saw two oncologists (one and RO the other a MO) who were both very pro ADT but they didn’t provide convincing evidence that ADT would provide substantial benefit. I went with a third RO who was more agnostic on adding ADT, and who respected the research I did and conclusion I reached. My PCP has also been in my camp and he has been a great sounding board for me, providing critical feedback on my literature review and thinking about the risks vs benefits of ADT. Clearly, not a straightforward decision, but with my particular recurrence, I have felt equal concern for over treatment as well as under treatment. If things take a turn for the worse down the line, I will completely re-evaluate, but I am encouraged by your experience and remain optimistic for a good outcome from the IMRT alone. Best wishes for continued good numbers.

@crusader76
A 3+4 Doesn’t really call for ADT. Of course, if you don’t have a prostatectomy, you can’t be quite sure what your Gleason score really was.

It is pretty routine to do ADT before SBRT radiation. Usually, docs don’t go past six months unless there’s a high Gleason or some other aggressive thing found in the biopsy.

My brother was a 4+3 and at 77 had a six month shot before SBRT and none after. The hot flashes followed him for 9 months. Even 2 1/2 years later, he tells me he feels mild ones occasionally

@pesquallie I LOVE hearing things like this. Things are being developed everyday it seems.