ADT, maybe not? Anyone opted out of ADT?

@wilke333
Surprising to hear only one week of ADT with a quick occurrence after surgery.

Radiation can be effective but I’ve never heard of anybody having such a short stint of ADT after a reoccurrence.

They gave you Fermagon it sounds like. That is probably the most unpleasant way to get ADT.
If you need to get it again, ask for Orgovyx pills. Once a day.

I think it would make sense to go to a center of excellence and get a second opinion on your treatment.

@daveslp
If both of the Artera Test and the decipher test show that you have a low chance of reoccurrence than ADT is frequently not given, Something the doctor will actually discuss with you, but I know many doctors have said that people don’t need it with low test results.

I know somebody who right now has a 3+4 Gleason score and has large cribriform, which is very aggressive. His ArteraAI, Polaris and Decipher all came back very low and he’s decided to go on active surveillance, Something he’s had a few doctors agree with. So you were wondering about using ADT and he’s doing nothing, Except testing in the future.

I have never heard of the Arterra Test and the decipher test. Is this something new? I had to stop Lupron after 4 months or thought I would die because of very severe side effects. I had 44 radiation treatments along with the Lupron.

My doctor never suggested anything but Lupron and did not tell me much about the side effects. I have absolutely no libido or errections five months after treatments and my PSA < 0.1 and testosterone is < 9 at 1 month and 4 months after stopping Lupron. At 5 months after stopping Lupron I still have all the side effects but they seem to be very slowly decreasing except for joint pain.

@pesquallie
Both the ArteraAI and Decipher Tests are relatively new. The decipher was starting to be heavily used in June 2025, the ArteraAI test in August 2025. These are tests that really have Been needed, but have just recently been heavily used.

The UCSF prostate cancer system uses it for almost all of their patients.

Then there is the Polaris test which has been around since 2010. Similar way to predict reoccurrence.

Lupron can be tough to deal with For some people. The thing is, it does extend lives. Hopefully, you can find something that works for you.

@pesquallie Orgovyx is oral, much better tolerated and can be stopped, with symptoms gone within a week.
But how would YOU know if your doc never mentioned it? I did happen to know about it so I asked about it and my RO totally agreed. SE’s were minimal in my case, but a few men still have problems with it.
Phil

@heavyphil Decipher just came back at .57. I am planning to give Orgovyx a try. Thanks for the input.

@pesquallie
Not familiar with Arterra Test. The Decipher has been around for some time. Mayo Jacksonville R/O recommended I take it back in January of 2023.

The Decipher test is something I personally suggest as it really had an impact on my personal experience with PC. I was originally diagnosed at intermediate risk PC. The Decipher test came back low risk.

It changed my treatment plan from radiation with hormone treatments to radiation only. I also believe it can really help more accurately define your risk level much better than Gleason Scores.

I have read many many posters experience with hormone treatments. I cannot comment on hormone treatments as have no personal experience with them. But from what I read over many many posts that everyone is different it how they respond to the hormone treatments and clearly that what one will post as their experience does not mean you will mirror it.

My Decipher came back at .92. The quality of my years are more important to me than the quantity of years.

I was 69 when diagnosed with 3+4 in January 2023. The urology clinic that did the biopsy automatically sent a sample for Decipher testing which came back in the high range. My decision was to do radiation (VMAT) and the urologist planned to give me ADT injections. But the RO was adamant that ADT was not only unnecessary but potentially harmful. He convinced the urologist and I received 39 radiation treatments without any ADT before, during, or after. I am now in remission with a PSA around 0.30 during my last two checks. No long term side effects to date. Hoping the smooth ride continues indefinitely.

@dgd1953
Per my Gleason score I was given a intermediate risk which R/O stated recommendation would be radiation and hormone treatments. R/O ordered Decipher test, bone scan and PSMA.

My Decipher came back low risk versus you "high range" and my treatment was changed from radiation with hormone to just radiation only.

I would inquire what your urologist or R/O meant by high range to a more specific low risk, intermediate risk, or high risk. Those determinations per my Mayo urologists and R/Os are guiding factors of whether hormone treatments are recommended.