Should 80yr old have aggressive treatment for metastacized cancer?

@climateguy I've approved for Orgovyx at no charge but for now I'm not doing it. My Urologist wants me on it but RO does not want me on it. My Urologist is willing to go with what my RO says for now. My Uroligists that I saw today and my RO wants to see what my PSA is in a month and we'll go from there. My RO said if it rises I'm determined to find and zap it too.

@pemarq

I was in the same position and age as you about 15 months ago. I had 44 radiation treatments plus 4 months of Lupron. I had to stop the Lupron because of very painful bone and muscle pain plus headaches that were severe for 9 months after treatment ended. Now at 11 months after treatment myside effects are about 10% of 2 months ago and my PSA < 0.03. I get another PSA in July and hope for the best. Most people do not have the severe side effects as I did. Mine were so severe that I believe continuing Lupron would have killed me. If I had to do it over again, I would want to try a pill type ADT that could be stopped or slowed on a daily basis. A 3-month Lupron shot can be fully effective for up to 9 months and by then you would have had 2 more shots. I feel that Lupron is severely over dosed for me and many people.

@pesquallie I need to point out that not everyone who gets Lupron shots has terrible side effects. My husband has been on Lupron forever, initially a shot every three months, and then he changed to a shot every six months when he began getting the shots locally. He has not had terrible side effects that caused him to stop Lupron. I guess I would say don't refuse it until you give it a try.

@pemarq, choosing not to have treatment is a personal choice and an option. To inform your decision, I suggest asking very targeted questions of your cancer team, like:
- What are the risks and benefits of treatment specially for me (age, health status, diagnosis)?
- What would progression of disease and quality of life look like for me if I were to do radiation only? ADT only? No treatment?
- My goals in life are ________. Would having treatment allow me to do this?

As others have mentioned, with or without treatment, you might ask for a consult with palliative care. Palliative care helps with full person care and symptom management. Do you know about palliative care? Did you make a decision about treatment or next steps?

@colleenyoung

The problem is that everyone seems to act differently to each treatment. Duke Health studies indicate that everyone is different and there is a need to match the treatment to the person. They are using AI to determine the differences so that an individual gets the best treatment for his unique case.