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ADT, maybe not? Anyone opted out of ADT?
Prostate Cancer | Last Active: 29 minutes ago | Replies (84)Comment receiving replies
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.
Replies to "The choices are yours. It is your body. I had SBRT radiation a year ago. PSA..."
@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
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@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.