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Starting ADT
Hi All,
My first post in the un-fun club. I'm looking for some advice on my next step. First some history: I was diagnosed in the summer of 24. The biopsy yielded T1, N0, M0 with a Gleason of 3+4. Two positive out of 13 sections. Seemed mild. I did the brachytherapy in Sept 24 and had been monitoring since. My PSA peaked at 10.8 just before the radiation then slowly came down. In Sept 2025 it reached 4.08. I was feeling good. Since then it started going up again. Last test in Feb 2026 was 6.6. I then got a PET. It showed both lymph and some small uptake in the bone.
I've seen one medical oncologist who is now recommending ADT with Eligard once every 12 weeks and a daily dose of Abiraterone and Prednisone. I'm wondering if others are on this regimen or if there are any other alternatives. The radiologist who did the brachy is not recommending any external radiation at this time and also recommends ADT.
This is my 2nd rodeo with cancer have survived thyroid cancer from 2006. BTW, I'm 62. I'm kind of freaking out because this one is more serious and the stats look depressing. I'm just looking for some guidance outside of the doctor office from people who have been in the trenches.
Thanks, Damon
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@jeffmarc Yes, I am seeking out other opinions. I've got an appointment with a lead at UCSF (I'm in the SF Bay Area). I've also reached out for some contacts at Stanford. Unfortunately these are taking time to get and I really want to get started. Is there a downside to beginning with the prescribed path (Eligard w/ Abiraterone & prednisone) and continue to research other treatments like alternative meds or even radiation/chemo?
@damonk
People that have tried both UCSF and Stanford have found UCSF to be more attentive and more directed in treatment of prostate cancer patients.
You need to speak to a doctor that Specializes in prostate cancer, A Genito urinary oncologist. At UCSF Dr. Rahul Aggarwal is a specialist you would really benefit from working with. Because your case came back after treatment, this is the doctor that you should see.
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2 Reactions@jeffmarc Thanks for the reference. The person I have an appointment with on the 24th is Dr. Eric Small.
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1 Reaction@damonk
Also a good doctor. Rick Davis, who founded ancan.org is not A big fan of Dr. Small. He has not found his treatment choices to be optimal for all situations. You might attend the ancan.org Weekly advanced prostate cancer meeting on Tuesday. It meets at 3 PM Pacific time. You have to install GoTo meeting and put in answercancer for the meeting name. If you get there, 10 minutes early, you will be first for them to talk with you about treatment for your situation. They’ve been doing it for 17 years and really know ideal treatment. There are also usually three doctors in the meeting if not more.
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1 Reaction@jeffmarc thanks Jeff. I will try to make it.
I had Gleason 9 (4+5) with 11 of 14 tissue samples positive for PC. I opted for radiation and ADT after being told that at my age (75), I had a good chance of being incontinent for the long term if I had surgery. So far, so good. I just finished a 2 year treatment schedule and my PSA has consistently been at 0.0. I will continue monitoring PSA every 3 months to see if it returns. I am very happy with the results. The worst part were the hot flashes. Best to you on your journey…
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2 Reactions@sicernon3
There are many solutions for hot flashes. I had really severe hot flashes for the first year and then my oncologist recommended a depo-provera Shot every three months. Made a major difference.
The Mayo Clinic doctors have recommended a number of drugs that you can take to stop or reduce hot flashes. I’m including a slide from one of the presentations With that information.
@jeffmarc Hi Jeff, the AnCan meeting yesterday was quite interesting and informative. I'm going to talk with UCSF before doing anything. The group didn't seem enthusiastic about my current path of Eligard w/ Abiraterone. I still have my appointment with Dr. Small on the 24th. I tried to get an earlier one with Dr. Aggarwal or Dr. Friedlander but they are scheduling beyond the 24th. They offered an appointment with Dr. Kelly Fitzgerald for next week. Do you have any knowledge of her? Or, how would I contact a moderator of yesterday's meeting to ask that question?
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1 Reaction@damonk
Well, I think Rick said it during the meeting he would prefer Dr. Aggarwal or Dr. Friedlander to Dr. Smith. This is something I told you about before the meeting and why I mentioned you might want to come to it. Smith doesn’t seem to be real friendly with the people that are his patients, Though Rick said he is quite competent.. If you do see him, you may not be able to switch to one of the other doctors. You could call up UCSF and ask about that.
He didn’t know about the other person you might check with Rick.
You can contact Rick by email at. Rd@ancan.org
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1 ReactionI am wondering why the Drs did not seem enthusiastic about your ADT recommendation, are you on it now? I am on Orgovex and Abi...almost 3 weeks in and doing OK. PSA check in a couple weeks. Wait and see.....