← Return to ADT, maybe not? Anyone opted out of ADT?

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bob1955 avatar

ADT, maybe not? Anyone opted out of ADT?

Prostate Cancer | Last Active: 3 hours ago | Replies (83)

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Profile picture for jeff Marchi @jeffmarc

@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

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Replies to "@rbtsch1951 Not sure you saw this message I posted Some unique finding of the below study..."

@jeffmarc Thanks Jeff for sharing that. Brand new and hot off the press, I see. I’m sure that’s why my RO is recommending 12-18 months rather than the longer duration (up to 36 mos) suggested by the NCCN guidelines (which are constantly evolving as new data accumulates).

@jeffmarc Thanks for the article, Jeff…that study is a long time coming!
Quick question: What about your own situation? You are -ahem- not a young man and you have been on various forms of ADT for many years.
You’ve mentioned trying to go off ADT, but had a rise in PSA so had to resume…
Is it simply a case of choosing the lesser of two evils?
Phil