What is treatment for Gleason Score 8 at 80 years old in good health?

I think this is your second post regarding your treatment; so you’ve ruled out surgery - a big first step.
Now you and your RO can decide on what type of radiation: IMRT - multiple sessions of (20-39) low dose therapy.
SBRT - 5 sessions of high dose therapy
HDR - a boost of very high dose (via seeds, etc) followed by either IMRT or SBRT.
All of these have the same goal but some - and only in some men - have more SE’s than others; usually the higher dose. There is a test (whose name escapes me) to see how you might tolerate higher dose radiation so ask your RO.
ADT is going to give you an extra margin for success, no two ways about it. But how much that is varies from 3-10%, depending on what you read or whom you ask. At age 80, perhaps the actuarial tables would say not to bother since you are already living longer than the average adult male in the US.
But that is an average - not an indicator of YOUR current health status. You’ve indicated that you are in excellent health with no co-morbidities so you have a very good chance of living 10 more years and beyond. So ADT could prevent recurrence in your lifetime.
That said, you could drop dead tomorrow from a heart attack in excellent health…people do die.
So the decision to ‘ADT or not to ADT’ is really a coin toss and how comfortable you are with that decision.
And just to confuse matters more, side effects from ADT vary from person to person SO MUCH, that you cannot predict how you will react. But if you take Orgovyx - an oral form of ADT - you’ll know within 6 weeks or so how much you are affected by it; so you CAN stop it and recover very quickly.
Lupron (and others) is an injection and its effects ‘spike’ soon after and are usually much more pronounced. But it’s now in your system and will take months to wear off. You really don’t want that. Best,
Phil

What type of radiation and hormone therapy would you suggest for a 80 year with a Gleason Score 8 contained to prostrate, particularly the hormone blockade, since that can potentially be devastating both physically and emotionally.

What type of radiation and hormone therapy would you suggest for a 80 year with a Gleason Score 8 contained to prostrate, particularly the hormone blockade, since that can potentially be devastating both physically and emotionally.

I think this is your second post regarding your treatment; so you’ve ruled out surgery - a big first step.
Now you and your RO can decide on what type of radiation: IMRT - multiple sessions of (20-39) low dose therapy.
SBRT - 5 sessions of high dose therapy
HDR - a boost of very high dose (via seeds, etc) followed by either IMRT or SBRT.
All of these have the same goal but some - and only in some men - have more SE’s than others; usually the higher dose. There is a test (whose name escapes me) to see how you might tolerate higher dose radiation so ask your RO.
ADT is going to give you an extra margin for success, no two ways about it. But how much that is varies from 3-10%, depending on what you read or whom you ask. At age 80, perhaps the actuarial tables would say not to bother since you are already living longer than the average adult male in the US.
But that is an average - not an indicator of YOUR current health status. You’ve indicated that you are in excellent health with no co-morbidities so you have a very good chance of living 10 more years and beyond. So ADT could prevent recurrence in your lifetime.
That said, you could drop dead tomorrow from a heart attack in excellent health…people do die.
So the decision to ‘ADT or not to ADT’ is really a coin toss and how comfortable you are with that decision.
And just to confuse matters more, side effects from ADT vary from person to person SO MUCH, that you cannot predict how you will react. But if you take Orgovyx - an oral form of ADT - you’ll know within 6 weeks or so how much you are affected by it; so you CAN stop it and recover very quickly.
Lupron (and others) is an injection and its effects ‘spike’ soon after and are usually much more pronounced. But it’s now in your system and will take months to wear off. You really don’t want that. Best,
Phil

I think this is your second post regarding your treatment; so you’ve ruled out surgery - a big first step.
Now you and your RO can decide on what type of radiation: IMRT - multiple sessions of (20-39) low dose therapy.
SBRT - 5 sessions of high dose therapy
HDR - a boost of very high dose (via seeds, etc) followed by either IMRT or SBRT.
All of these have the same goal but some - and only in some men - have more SE’s than others; usually the higher dose. There is a test (whose name escapes me) to see how you might tolerate higher dose radiation so ask your RO.
ADT is going to give you an extra margin for success, no two ways about it. But how much that is varies from 3-10%, depending on what you read or whom you ask. At age 80, perhaps the actuarial tables would say not to bother since you are already living longer than the average adult male in the US.
But that is an average - not an indicator of YOUR current health status. You’ve indicated that you are in excellent health with no co-morbidities so you have a very good chance of living 10 more years and beyond. So ADT could prevent recurrence in your lifetime.
That said, you could drop dead tomorrow from a heart attack in excellent health…people do die.
So the decision to ‘ADT or not to ADT’ is really a coin toss and how comfortable you are with that decision.
And just to confuse matters more, side effects from ADT vary from person to person SO MUCH, that you cannot predict how you will react. But if you take Orgovyx - an oral form of ADT - you’ll know within 6 weeks or so how much you are affected by it; so you CAN stop it and recover very quickly.
Lupron (and others) is an injection and its effects ‘spike’ soon after and are usually much more pronounced. But it’s now in your system and will take months to wear off. You really don’t want that. Best,
Phil

@heavyphil

Lupron effects for the majority of men last 3 to 6 months after scheduled treatment ends. This indicates to me that the typical Lupron dosage is 3X what it should be for most men. My last 3-month Lupron shot lasted for 9 months of severe side effects, PSA undetectable, and testosterone < 9. Now at 10 months my testosterone is starting to rise (122) and I still have all the side effects, but they are much milder. One dosage level for all men concerns me since it would seem wise to give no more of the ADT than needed since it is known to harm bones, heart, brain function, and muscles.

What type of radiation and hormone therapy would you suggest for a 80 year with a Gleason Score 8 contained to prostrate, particularly the hormone blockade, since that can potentially be devastating both physically and emotionally.

Thanks, Jeff,
I agree but my concern is if a 3-month Lupron shot can keep the testosterone down for 6 months or more why should one have a shot every 3 months. It looks like overkill to me. A standard 6-month Lupron shot has double the volume of a 3-month dose, so the medical field has made the issue all about the volume of the shot. I just do not believe that one size fits all men. This is also a major problem in the medical field that prescribes the same prescription dosage for a 100-pound and a 300-pound person.

What type of radiation and hormone therapy would you suggest for a 80 year with a Gleason Score 8 contained to prostrate, particularly the hormone blockade, since that can potentially be devastating both physically and emotionally.

@pesquallie
The dosages of Lupron are tested with 100 and 300 pound people. The size of the person is not relevant. The Lupron dosage breaks down in the body at almost an identical rate for everyone. I was on 6 Month Lupron shots for six years. I also had monthly PSA and testosterone tests. My testosterone did not rise at the end of 6 months. I am 6‘4“ tall and weigh almost 200 pounds. For people on ADT there may be a few days difference In testosterone levels, but that’s about it. Trials have shown If the Testosterone gets above 50 that can cause issues. Doing intermittent ADT may just not be beneficial as a result.