Lupron or Not at 76?

Posted by tbgb50 @tbgb50, Aug 1 10:36am

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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chippydoo | @chippydoo | 5 days ago

What country are you being treated in?

tbgb50 | @tbgb50 | 5 days ago

In reply to @chippydoo "What country are you being treated in?" + (show)

@chippydoo US

chippydoo | @chippydoo | 4 days ago

In reply to @tbgb50 "@chippydoo US" + (show)

@tbgb50 Can you get Orgovyx instead of Lupron? Can you get the patch? Those two are easier on you and you will start feeling better around 3 weeks post treatment on Orgovyx, and I've heard the patch allows you to keep your quality of life. I would roll the dice on RP if your health is good enough to get it. No ADT unless you BCR. You're on the lifetime clock at 76 and 2 years of Lupron is a tough life during the later half of the treatment. Quality of life is an issue. Your doctor just wants to treat and leave you to figure out how to feel better. I have a friend that did radiation at 71 and is at 19 months on Lupron and just dreading it. I was Gleason 9 Grade 5 with RP at 69 and BCR at 71. Lupron was tough on me and also went anemic so changed to Orgovyx after 3 of my 6-month Tx. Radiation side effects were a bitch too, with radiation proctitis and enteritis. Have you talked to a surgeon? Best wishes with whichever route you choose.

tbgb50 | @tbgb50 | 4 days ago

In reply to @chippydoo "@tbgb50 Can you get Orgovyx instead of Lupron? Can you get the patch? Those two are..." + (show)

@chippydoo Orgovyx is my plan, assuming I can convince the urologist. I agree quality of life is an important issue. My argument is going to be just what you said - the half life takes me to 80 YO and the radiation oncologist said you likely won't get over all of the side effects at that age but which ones no one knows. My brother's neighbor is a year younger than me but better PSA and Gleason scores - he just quit Lupron after 6 months even though the recommendation was 12 months. Couldn't take it.

chippydoo | @chippydoo | 4 days ago

Why not RP? Is health a factor? If you BCR salvage is 25-35 sessions with a shorter ADT period.

tbgb50 | @tbgb50 | 3 days ago

In reply to @chippydoo "Why not RP? Is health a factor? If you BCR salvage is 25-35 sessions with a..." + (show)

@chippydoo Age is the issue - I got a second opinion to confirm.

chippydoo | @chippydoo | 3 days ago

Dang sorry to hear that. Praying for a positive outcome for you.

utahgearhead | @utahgearhead | 3 days ago

I’m 76, Gleason 4+3 along with initially suspected seminal vesicles & rib involvement Docs suggested 18-24 months Lupron and several radiation doses.

I decided to get a second opinion right after getting the first 6 month Lupron injection. The second RO after looking at my chart immediately suggested only 6 months Lupron and 5 SBRT sessions. I had the first session today.

My two cents on Lupron is much like a lot others. I’m into it 3+ months. The night sweats, achy joints, no sex drive and even the brain fog, I can deal with. It’s the potential bone loss, lack of energy and loss of strength and mood. It’s the first time in my life I actually feel old.

After 3 months I’ll have a PSA and see my RO.

I have no want, nor at this point in my mind will go on Lupron again. Combined with the aging and time left, quality of life it’s all there to choose. But I can’t imagine my physical & mental body after 18 -24 months.

pesquallie | @pesquallie | 3 days ago

Lupron can be really rough on the body. At age 82 I had about the same cancer diagnosis as you but opted for 44 radiation sessions and 18 months of Lupron. The Lupron side effects were so bad that I thought they would kill me, so I stopped at 4 months, but the effects lasted another year. I immediately became hypogonadal due to the Lupron and 3 weeks ago started TRT to get above my 111-testosterone level. Within 5 days I got some libido back and soft erections plus felt so much better. A number of recent studies now agree that TRT does not raise the risk of cancer return. It seems that testosterone is not the big driver of prostate cancer as they used to believe.