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Lupron or Not at 76?
Background - biopsy in 2022 was completely clean. Biopsy in 2026, Gleason 9. PET shows cancer is localized.
Had first appointment with oncologist yesterday. Recommended 5 weeks of Photon radiation treatments and 2 years of Lupron. I'm fine with the radiation but:
I was told the success rate is 80% for the radiation and another 5% with the Lupron. One problem is the 80% success rate is not based on age groups so it's difficult to decide if the Lupron is worth it because:
I was told at 76 the 'recovery period' for Lupron = the amount of time you get the treatment. So 2 years of treatment + 2 years of recovery = 4 years. I'd be 80 and I was told at this age you often don't see the side effects of Lupron reverse so it seems high risk for not much reward.
Am I thinking about this correctly?
Has anyone roughly my age gone with Lupron and really regretted it? Why
THANKS!
FWIW at this point I need to decided between:
Radiation only
Radiation + 1 year of Lupron (my idea)
Radiation + 2 years of Lupron (recommendation from urologist and oncologist).
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Hi,
If it was me I would not do the Lupron and go with one of the newer ADT drugs like Orgovyx. Orgovyx is a daily pill form with better self control if you have reactions. You stop taking the pill. Lupron last several months so if you do have reactions you have to suffer for months. Just my humble non medical opinion.
Dave 3+4
I’m 74 with Gleason of 8. Urologist said 7 weeks radiation and 2 years hormones. I didn’t like idea of hormones so he said casually, “ if side effects are intolerable just stop them.” Oncologist said recommendations were 28 radiations and 6 months hormone therapy depending on side effects you’re willing to tolerate. I chose radiation only and am two weeks post radiation therapy. Side effects have not been bad, taking Flomax now but feel side effects diminishing. No PSA yet but just could not agree to hormones. Good luck.
@clevelandguy That's where my thinking is headed unless Gleason 4+5 is better treated with Lupron. I'm bummed out the urologist wants to do the Lupron so I have to wait to see him on 8/25 to discuss Orgovyx. I'm fairly certain this will require a debate. I don't see how I can do Lupron for 2 years and ever recover at my age.
@pesquallie If Lupron is my only option then I'm going to ask for no more than a 3 month shot. The way the oncologist explained things, the radiation has an 80% success rate for high risk PC and the Lupron adds another 5%. My problem is understanding the 80%. It's an average based on your risk scores but does not consider age. I can't believe people in their 70s have the same success rate as those in their 40s or 50s.
Seems like high risk low reward at my age (76) so the 3 month shot can hopefully allow me to bail if it is too much for me and still recover.
@tbgb50 Lupron creates a flare (higher testosterone) for the first 2-3 weeks. It takes 4-6 weeks to drop testosterone to castrate levels. It also takes 3 or more months after the expiration of the shot to recover testosterone. A 3-month shot will give you about 5 months at castrate levels (or more if your testosterone does not recover). Failure to recover testosterone is highly correlated to age (especially 80+) and length of time at castrate levels. A much higher percentage recover testosterone at less than 70% of pretreatment levels.
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Hug
1 Reaction@paullvlc In my case, the Oncologist has recommended 28 radiation treatments (will start 9/1). Initially, the oncologist said Lupron for 24 months but was just repeating what the urologist recommended. When I questioned him, he said the choice was mine i.e. no hormone treatment or choose how many months. It's finally sunk in that you need to make decisions without much advice outside of standard protocols. My first choice is to get Orgovyx but I don't see the urologist for a couple of weeks.
@tbgb50
I hope he will understand, it’s your body and he should have some compassion for that.
Dave 3+4
@jim18
I was 82 when treatment started and 83 when it ended. Side effects were awful and it took about 10 months to even start recover from side effects and a testosterone rise to 111. Side effects did not stop until I started testosterone replacement treatment just 2 weeks ago.
@jim18 Thanks for the information - especially regarding age since that is my dilemma. The oncologist said my testosterone recovery = the length of treatments. So based on their recommendation a total of 4 years. He also said I may not recover much since I will be 80 then. This get worse and worse as far as making a decision but at least I have more information. I know there is no guarantee but I'm reaching the point where it is Orgovyx for a short time or changing urologist if I get push back.
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1 Reaction@tbgb50
There is really no difference between Lupron and Orgovyx And how effective they are in dropping the testosterone. One benefit is you don’t need to take Casodex for two weeks before starting Laura. If your doctor doesn’t do that, you need to find a new doctor.
Lupron has A problem Where it builds up arterial sclerosis in the heart arteries. In the first year, it does this. Orgovyx Does not do this.
When you stop orgovyx Your testosterone comes back much quicker than if you are on Lupron.
Just some things to talk with your doctor about.