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PSA "undetectible" for amost a year
Prostate Cancer | Last Active: 5 hours ago | Replies (13)Comment receiving replies
@soli Yes to all that. I had a good ten years, hardly ever thinking about the prostate cancer, but aware of the post-surgery pathology. When deciding about treatment for the relapse, I had the option of doing ADT. It was a gray area decision, and a lot of factors went into my final decision to forgo ADT and just go with radiation. One of those factors was that I could save the ADT for when and if I required it (and when the benefit to risk ratio was better). And also that in 2, 3, 5 years and beyond, there would be new and improved therapies. Someone else, just as reasonably, might have gone for the “hit it with everything” option, but that was not and still isn’t my approach. Treatment is a mix of medicine, science, statistics and personal values and priorities.
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@melvinw
I agree. To be sure, some treatment decisions are clear-cut, but many are much more nuanced. Like you suggested, we have to weigh multiple factors, including the risk-benefit ratio (potential for cure or improved outcomes versus side effects), age, comorbidities, quality-of-life priorities, and personal values before deciding whether to accept treatments such as ADT.
Guidelines and our understanding of ADT have also evolved considerably in recent years, particularly regarding the recommended duration and which patients are most likely to benefit. What makes sense for one person may not necessarily be the right choice for another. Ultimately, treatment decisions are highly individualized and should be made based on both the best available evidence and what matters most to the individual.