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← Return to ADT and rising PSA
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Prostate Cancer | Last Active: 1 hour ago | Replies (27)
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@denis76
Must be the first time I have heard that. There have been Quite a few cases in this Mayo forum where people have gone aggressive as could be on their prostate cancer, and it helped.
People get triplet therapy to try to stop the cancer in its tracks and it works for a lot of people. It doesn’t work for everybody, Some prostate cancer cases can’t be stopped, not because people were too aggressive. It’s because their cancer is too aggressive..
I know someone that actually got triplet therapy when he didn’t have it recommended, but he wanted to be aggressive so that he didn’t have to worry about the future.
Normally, however, people get aggressive therapy because they have an aggressive case.
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As I've mentioned before, my treatment was unusually aggressive, even by leading-edge standards, because it also included surgical debulking of the metastasis in addition to the regular MDT, PDRT, and doublet therapy.
There is some research showing that surgical intervention for large metastases with oligometastatic PCa reduces recurrence risk even further, but it's not standard of care yet, especially if the metastasis is somewhere tricky like the spine: the risks are just too high (as the old surgeon joke goes "The operation was a success, and the patient died").
I got that intervention because I was at risk of permanent paralysis or death if they *didn't* operate immediate. Fortunately, there was a top spinal specialist on call that night, he drove in from home at zero dark thirty with no notice and no opportunity to plan, and not only was the 10+-hour operation a success, but I did wake up again. 🙂 So ex-post, knowing that I didn't die on the operating table, it was a good choice for me for cancer-control as well as mobility, but there was no way to know that ex-ante.
All my cancer treatments:
October 2021
- surgical debulking of the metastasis on my spine
- 20 gy of post-op radiation to my spine (MDT)
- ADT (first Firmagon, then Orgovyx) -- ongoing to present
- ARSI (Erleada) -- ongoing to present
May 2022
- 60 gy of radiation to my prostate (PDRT)
As of May 2026, I'm still NED, so in my case, the aggressive approach seems to have paid off, but as @jeffmarc mentioned, everyone's cancer is different.