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ADT and after stopping
Is it really worth the side effects doing ADT with localized PC? It only adds 5-8% advantage. Few thoughts and theories come to mind. Why not save the ADT for later in case a reoccurrence?
Just a theory but if you use ADT and when you stop wont that just give the cancer a chance to bounce back and maybe even be stronger? Maybe this is why there is such a high amount of reoccurrence? If anything maybe only do the ADT during the radiation treatment and stop when treatments end? Just throwing some thoughts out there.
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I think every single percentage point in your favor should be exploited; that 5-8% edge in investing translates to a financial windfall in investment circles - why not apply that same principle to fighting cancer?
The downsides vary so much from person to person, so they are just like in your financial prospectus…a lot of ‘maybes’, and ‘no guarantees of future results’…that’s life!
As of now, there is zero evidence that a short course of ADT makes PCa more prone to recur; in fact, even long duration ADT has not been shown to cause castrate resistance - it’s the clones themselves that were resistant from the get-go; they simply proliferate over time and become dominant over those cells that still do respond to ADT.
It all comes down to how you are hardwired. I’m the kind of person who can wallow in regret if a failed outcome is because I took the easy way out…I can’t live with that feeling, OK?
I’d rather ‘suffer’ in the short term - even if I fail - and know that I pulled out all the stops.
Yeah, I was raised Catholic and even though I no longer follow the faith, old habits die hard..,
Phil
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1 ReactionThe question if 5%-8% improvement is worth the negative effect of ADT is something each patient needs to decide for themselves. The rest does not apply. No evidence that previous ADT causes any worse outcomes if a patient goes metastatic and is put on lifetime ADT. There is evidence that for many patients short term ADT is almost as effective as longer terms. Also, adjuvant (post) ADT more effective than neoadjuvant (pre) ADT when combined with radiation. In addition to the decision of yes or no there is a yes-but where the patient limits ADT to get the most benefit with the least side effects.