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ADT or no ADT? What should I ask my Oncolgist?
Prostate Cancer | Last Active: May 28 7:09pm | Replies (50)Comment receiving replies
I’m new here and about to start stereotactic radiation for a Gleason 7 (4+3) and decipher score of .68. That’s the bad news. The good is that its localized and .7mm at the anterior transition zone with a negative psma pet and past 2 PSA labs have been under 2.2. I chose SBRT after researching and found same curative results of Robotic vs radiation with radiation having less percentage of side effects ( incontinence and ED). After talking w a few people who had robotic radical prostatectomy, they wished they went w SRBT. My issue is that although I unfavorable intermediate risk by Gleason and “low” high risk based on decipher I would prefer to not start ADT due to the muscle wasting, bone resorption, fatigue. I’ve been given Orgovyx but have not taken it. First treatment is tomorrow. It really comes down to risk of micro metastasis and the SRBT eliminating the localized cancer. I’m leaning towards no ADT and monitor for biochemical recurrence via PSA and pet scans. Any advice/comments. ( I have a background in health care).
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@zeits53
The muscle and bone deterioration from six months of ADT are not really a big deal. The benefit they can give for preventing the cancer from coming back Can be significant.
I’ve been on ADT for eight years now. I go to the gym three times a week to keep my muscles up and I’ve been on bone strengthener for about the last seven years. Didn’t need them the first year.
I had six months of ADT when I had eight weeks of salvage radiation, I was 64 and didn’t even notice that the ADT affected me. My brother had SBRT radiation at 77 and they gave him a six month Lupron shot. It did give him hot flashes, but that was the only side effect he noticed. They went away about nine months after the shot wore off but got milder as that time went on.
Orgovyx has the least side effects of any of the ADT drugs. The testosterone comes back real quick after you get off of it most people get it back to real good levels after three months.
You’re probably going to benefit a lot more from taking ADT than not taking it. With the relatively high decipher score you have, it would make sense to take it.