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Hormone therapy before radiation treatment question....
Prostate Cancer | Last Active: Mar 29 11:12am | Replies (39)Comment receiving replies
Thanks for clarifying. I was also diagnosed as T3b and my doctor encouraged
me to remain on ADT for 2 years *after* my PSA first became
undetectable. That put me into the summer of 2027. I asked about taking an
ADT holiday (pausing for a few months and then starting again). He said he
didn't like that idea. I thought the benefit might be higher than 20%. I
truly would love to get off the ADT, but ......
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@stew80 I accepted the idea that I would give staying on ADT for whatever time my RO suggested my best shot regardless of the various bad things I've heard about it.
I.e. I heard a recording of a urologist speaking to an audience of other urologists who said: "ADT wrecks old men's lives. We all know that". I also didn't like the available data that indicates that the longer a patient is on ADT, the less likely it is that their testosterone level will recover to the level it was pre-ADT. And, many patients never recover their testosterone.
However, I came to agree with those who state that ADT drug therapy is about as good of a drug therapy that exists in cancer care, because in so many cases it can set the cancer back significantly for very long periods of time. It also seems to allow radiation to work better. I decided to accept whatever the data showed in the way of ADT length given the particular definitive therapy I eventually chose.
After I decided on radiation as my primary treatment, I looked for if there were radiation treatments that called for less ADT time. There are.
I eventually chose 20 sessions of external beam, plus a high dose brachytherapy boost. The TRIP study examined if there was a difference between groups of men who were all given this same radiation combination therapy. One group were given 6 months of ADT and the other had 30 months.
The study was designed to show the superiority of 30 months of ADT. There was no meaningful difference in any measurable outcome between the two groups of patients.
The TRIP study would not have accepted me as an eligible patient because the cutoff for eligibility was stage T3a, and at T3b my case is too high risk.
However, my RO is now talking about 1 year of ADT rather than 2 years.
Nelson Stone discusses the TRIP study in the video entitled "Radiation Dose and Hormone Therapy: How Much is Enough?". He supervised the criteria for all the centers who administered the radiation treatments for this study to make sure the delivered dose were as uniform as possible no matter what center the patients were treated at. The TRIP discussion is about halfway into the video.