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Trying to decide on treatment for prostate cancer
Prostate Cancer | Last Active: Apr 12 10:36am | Replies (38)Comment receiving replies
@jeffmarc
Yep, ADT is definitely the current standard of care. And I'm glad it is not affecting you. I recommend looking at the video from the PCRI titled " Intermediate Risk: Radiation without ADT" (I don't think you can post links here or else I would do it). To summarize the video, the vast improvements in radiation accuracy and pre/post treatment monitoring (PET scans, MRIs, etc) over the last 10 years, have shown that not everyone needs ADT. Granted, this is one perspective and we all need to do what we think is best for ourselves.
Replies to "@jeffmarc Yep, ADT is definitely the current standard of care. And I'm glad it is not..."
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@johnt15
You can post links here, but you have to wait about a month after you join before you can do it. You probably have noticed a lot of links from other people.
I’m actually familiar with the NCCN guidelines which show when people should have ADT. Your PSA is not high enough to require it, but I’m not sure if you are a T2b or c or higher.
Another important thing is is any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive and make ADT more desirable.
My brother at 77 had a 4+3 and they had them on 2 3 month shots of ADT when he had Five sessions of SBRT radiation. They can have a difference on recurrence.
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)