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ADT, maybe not? Anyone opted out of ADT?
Prostate Cancer | Last Active: 3 hours ago | Replies (83)Comment receiving replies
PC therapies are a moving target as medical science accrues new data regularly. In the meantime, I am most comfortable sticking to standard of care guidelines outlined by the NCCN guidelines (the updated 2026 guidelines have recently been published). In my circumstance (Gleason 4+5) disease (progressed from 3+4) after 4 years on AS, I am willing to accept ADT recommendations in spite of the side effects. At 74 yr old an otherwise feeling well, I want the very best odds for long term disease control .
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@rbtsch1951
Not sure you saw this message I posted
Some unique finding of the below study were:
1. All endpoints tailed off significantly after 9-12 months albeit with marginal improvements and fewer prostate specific deaths. High risk men had the least to gain beyond 12 months .
2. Increased duration, especially over 18 months, resulted in greater other cause deaths, albeit fewer prostate specific deaths. In the past only cardiovascular deaths were seen to increase with more ADT.
3. For very high risk men, the length of time should be tailored individually over 12 months.
4. NCCN risk groups may not be the best way divide treatment
5. Shared decision making should be included in determining how long to stay on ADT
6. For younger, healthier high risk men, there may be greater benefit to staying on ADT longer than 12 months.
https://jamanetwork.com/journals/jamaoncology/fullarticle/2841671