Sorry to welcome you to our club.

Both the European Association of Urology ("EAU") guidance, and the National Comprehensive Cancer Network ("NCCN") indicate that for high risk prostate cancer, like yours, curative radiation therapy should be accompanied by ADT with a duration of 24-36 months (EAU) and 12-36 months (NCCN). Both agencies offer that comorbidities enter in to the decision regarding length of ADT.

You may want to consider Orgovyx as an option for your ADT, Orgovyx is a daily pill, the advantage of which is being able to stop taking the pill and having your testosterone return in a relatively short period of time as compared to a Lupron injection. If you choose a shorter term of ADT of it will likely have some benefit, just not the benefit that the standard of care would provide.

As patients and cancer survivors we must educate ourselves, advocate for ourselves, and in consultation with our doctors arrive at a treatment plan we are comfortable with. At that point hindsight and second guessing is not allowed. Move forward hoping for the best and ready for something less than optimal.

I was diagnosed at age 68 with one core 4+3, and one core 3+3. PSA was 7.8, and Decipher was .82. I was intermediate unfavorable. I was treated with 5 fractions of SBRT with a total of 36.25 Gy and a focal boost to 40 Gy at the primary lesion. I took Orgovyx for 6 months. I purposely lost 7 pounds prior to the Orgovyx and went to the gym 5 days a week doing cardio and weights. Additionally I walked 18 holes of golf twice a week. I took a calcium and Vit D supplement, and essentially stopped consuming alcohol. The SBRT was easy and the ADT was manageable. I did have some minor hot flashes from the ADT beginning on day 40. Additionally I had muscular aches generally in my arms. I chose Orgovyx for its quicker reduction and return of testosterone. Additionally while I had no intention of stopping my ADT, having the knowledge that I ____could____ and that I made the conscious decision to take the pill each day gave me some modicum of control in the otherwise out of control treatment world.

Two years later I have very minor side effects from the SBRT , my testosterone recovered (within the first two months post ADT) and my PSA is within an acceptable range.

All in all compared to others with various cancers I have had an easy ride.

Know that you will receive support in this forum. Also consider other forums such as https://www.inspire.com/groups/zero-prostate-cancer/discussions/ ( My username there is Toolbelt)

https://healthunlocked.com/prostate-cancer-community/posts (My usernamet here is ToolBeltZia )

https://www.reddit.com/r/ProstateCancer/new/ (My username there is Tool_Belt

If you like search for me in those, and this forum, for posts I have made about my journey.

Stay Strong Brother, We Got This.