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@brianjarvis
Hey,
He is 78 yo, and the Urologist recommended that at this age, orchiectomy is better vs monthly/quarterly injections, so there is no chance of missing it for any reason and relatively lesser side effects. Orchiectomy is also a form of ADT, (just not medical but surgical-if I am right). Gleason was 4+4, PCa as I mentioned above, was in one LN, and Sem. Ves. I will need to check ok the SUVmax scores.
For your ADT, was it a once in a quarter injection? I am not sure if the rate is psa decline with an injection vs orchiectomy are similar/comparable .... Haven't checked for Testosterone, but will do this soon.
Replies to "@brianjarvis Hey, He is 78 yo, and the Urologist recommended that at this age, orchiectomy is..."
@sbd (Note that they offer 6-month injections for the ADTs.)
If the cancer was identified in one lymph node, it had already escaped the prostate. They probably treated that lymph node during the prostate radiation treatments.
At 65y/o, my ADT was planned for just 6 months and was comprised of two 3-month injections of Eligard. (At 79y/o, my oldest brother is on Eligard right now; he’ll get quarterly injections for two years.)
While on ADT (or after an orchiectomy) it’s important to track testosterone levels; that’s what causes starvation/weakening of the prostate cancer cells, making them more susceptible to DNA damage from tge radiation, resulting in their death (and as a result, PSA dropping).
Good luck!
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@sbd
When someone is on ADT, their PSA may not get much below 20. If you add abiraterone It locates other places in the body that create testosterone and shut them down. This results in a much lower testosterone level. The same effect would be happening after an Orchiectomy.
I’ve heard of cases where it has taken three years for the PSA to reach rock bottom after radiation. His PSA has continued to drop.
There is an option to take one 250 mg abiraterone pill with a low-fat meal in the morning. It is just as effective as taking 1000mg. Not all doctors are really aware of this.
I was on 1000 mg of abiraterone For two years when I tried to cut back to 750 mg to see if it would ease the brain fog. After 19 days, my PSA rose from .2 to 1. In my case, just cutting back Abiraterone A little bit, directly caused my PSA to rise. Your father is not even taking the standard 1000 mg dosage. That could be a factor and why the PSA is not dropping more.
I am 78, I’ve had prostate cancer for 16 years and I’ve had four reoccurrences. I’ve been taking ADT for eight years. I am now on Nubeqa And have been undetectable for the last 28 months. I’m just bringing this up so that you realize that at 78 your father could have many more years to go because of the great drugs and other treatments we have available.