Is Hormone therapy necessary With radiation

Posted by Jeff Marchi @jeffmarc, 2 days ago

A few different people have asked about this in the last few days so here is some information about it.

Advantage of radiation and hormone therapy given at the same time greatly reduced
Overall survival—the chance of being alive years later—was nearly the same whether or not men received hormones with their radiation. After 10 years of follow‑up, 83.6% of men treated with radiation alone were alive, compared with 84.3% of men who also had hormone therapy, a difference of only 0.7%. Statistically, that small gap did not reach the usual bar for significance, meaning it may simply be due to chance.
However, the story changed when researchers looked at PSA level before radiation. Men whose PSA was 0.5 ng/mL or lower when they started radiation did not live longer if they added hormone therapy—whether they took it for a few months or for two full years. Men whose PSA was higher than 0.5 ng/mL, on the other hand, did see some survival benefit from adding hormones, suggesting that hormone therapy makes the most sense for this higher‑risk group.
The study also examined how long hormone therapy should last. Short‑term therapy (about 4–6 months) performed just as well as long‑term therapy (about 24 months) for most men in terms of overall survival. Longer treatment appeared to reduce the chance of the cancer spreading, but it did not clearly translate into men living longer overall in the general study population. Based on these data. Kishan summarized: for men who truly need it, a short course of hormone therapy is usually enough.
https://prostateblogmonthly.substack.com/p/do-all-men-need-hormone-therapy-after
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00137-6/fulltext

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

surftohealth88 | @surftohealth88 | 1 hour ago

In reply to @jeffmarc "@bikeman1 You’re on Casodex (Biclutamide) now, Which usually means they’re going to give you a Lupron..." + (show)

@jeffmarc
Jeff - his heart medication interacts badly with Orgovyx. His cardiologist put veto on it. 😟

surftohealth88 | @surftohealth88 | 1 hour ago

In reply to @jeffmarc "@northoftheborder That’s why I was puzzled that they did about the CT scanned and an MRI...." + (show)

@jeffmarc

CT is better for detecting lung mets since lungs are filled with air. MRI has trouble seeing things in lungs.

Combination of CT and MRI definitely covers all structures in the body.

bikeman1 | @bikeman1 | 56 minutes ago

In reply to @surftohealth88 "@jeffmarc Jeff - his heart medication interacts badly with Orgovyx. His cardiologist put veto on it...." + (show)

@surftohealth88
This is funny timing. While I was reading this thread, I got a message that my MO has prescribed the Estradiol patch for me at CVS::)) Yay! I have been telling all my docs I want that. So now the only questions for 6/16 MO appointment are: 1) do I stay on bical or switch to something else to go along with the patch? I am hoping for Nubeqa, and 2) for how long? I am currently setting up a Telehealth appt with MSK to get their opinions too.

Jeff Marchi | @jeffmarc | 48 minutes ago

In reply to @surftohealth88 "@jeffmarc Jeff - his heart medication interacts badly with Orgovyx. His cardiologist put veto on it...." + (show)

@surftohealth88
I remembered there was some issue with Orgovyx, So I went back and looked at what he said, And missed the small bit where he mentioned the conflict with his heart medication.

I’ve never heard of a problem with heart medication and Orgovyx. Would definitely like to hear what drug he has a problem with, since one drug I take is supposed to be a problem. It could be an Antiarrhythmics. Considering I have problems with heartbeats and just had to have cardioversion after an afib event, Makes me wonder if I have a conflict.

Just looking at drug Conflicts and I see that Diltiazem is listed as one of the drugs that can cause more Orgovyx To stay in the system. It is interesting that none of my doctors have ever mentioned that, and I take Diltiazem. I’ve had doctors pour over what medication’s I take before surgery so they can tell me which drug to stop and no one’s ever said stop that drug. Another drug I used to take, Coreg, Is also listed as a conflict. I’m the one that told my doctor I want to stop taking that I wanted to start taking metoprolol instead, both beta blockers.

I am actually going to do a little more research. Maybe my heart rhythm problems are due to a conflict.

wheel1 | @wheel1 | 28 minutes ago

In reply to @cbball "@brianjarvis Brian, you’re correct. Medicine advancements happen daily. A quick example: I went to a symposium..." + (show)

@cbball
Like you said advancements are constantly happening and as the prostatectomy was falling out of favor due to side effects and better radiation , boom it’s back now state of the art single port robotic, Retzius sparing technique, home same day as surgery, good chance of immediate continence for many, less ED. I think today treatment can be so tailored, with results becoming more comparable , it’s deciding between side effects you might need to live with, even the rectal issues from radiation have been minimized.

northoftheborder | @northoftheborder | 26 minutes ago

In reply to @jeffmarc "@surftohealth88 I remembered there was some issue with Orgovyx, So I went back and looked at..." + (show)

@jeffmarc I don't have heart issues, but I was on Perindopril Erbumine (Coversyl) + Diltiazem to control mild hypertension (aviation medicals are strict about that).

When I started on ADT and Apalutamide, they stopped the Diltiazem and switched me to Perindopril Erbumine / Indapramide (Coversyl Plus).

bikeman1 | @bikeman1 | 11 minutes ago

In reply to @jeffmarc "@surftohealth88 I remembered there was some issue with Orgovyx, So I went back and looked at..." + (show)

@jeffmarc
Jeff, I was taking Flecanide and Metropol for my very occasional tachycardia (not AFIB). It was the Flecanide that conflicted with Orgyvx. My cardio said stop Flecanide to allow me to use Orgyvx and just take more Metropol if I have an episode (which happens about 5x/year). This is now somewhat moot, since MO is prescribing the patch instead of Orgyvx. I will ask if the patch conflicts with Flecanide. If not, I may ask to go back on, since it seems to work well for me.