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prostate cancer ADT injection

Prostate Cancer | Last Active: 19 minutes ago | Replies (16)

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Profile picture for jeff Marchi @jeffmarc

@wwsmith Really hit the high points.

NCCN who sets the guidelines doesn’t call for 3+4 to have ADT unless there are other issues

Here are the guidelines, ask your doctor why he thinks ADT would be right for you since NCCN does not call for it.

NCCN Guidelines

Here are current NCCN Guidelines in 2025. They now suggest 0 (zero) months of ADT for low intermediate (GG2); 4-6 months for high intermediate (GG3), and 18-36 months for high risk (GG4 and 5). Actually, the footnote suggests ADT + abiraterone for T3b with lymph node involvement.
The meta-analysis suggests:
* 0 months for 1 intermediate factor (PSA 10-20, GG2 or 3, T2b-c)
* 6 months for 2 or more intermediate factors (PSA 10-20, GG2 or 3, T2b-c)
* 12 months for NCCN high risk (PSA >20, GG4 or 5, T3 or 4)
* undefined for NCCN very high risk (2 or more PSA >40, GG4 or 5, T3 or 4)

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Replies to "@wwsmith Really hit the high points. NCCN who sets the guidelines doesn’t call for 3+4 to..."

@jeffmarc When I first began studying prostate cancer, I would read about following the SOC (standard of care). I had always thought the SOC was some kind of unwritten typical treatment protocol for certain conditions. But now, if I am thinking correctly on this, following the SOC actually means following the most current NCCN Guidelines, right? And if that is correct, I am going to start mentioning that more in posts to new patients and even provide the link for the NCCN Guidelines https://www.nccn.org/guidelines/guidelines-detail

Like you have been doing, I think it is important for all patients to know what the Guidelines say for their condition so that they can compare what their doctors are recommending against the Guidelines. Deviations from the Guidelines are certainly ok if the doctors can make a good case for those deviations. But patients should always be involved in the process and be prepared to question and give their own input towards what is the best treatment for their particular case.