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When to stop adt treatment
I was diagnosed with prostate cancer 2 years ago. I went through 28 radiation treatments and was started on Eliqaurd and abiaraterone. All of my needle biopsies were 4+4=8 except one that was 3+4=7 and involved perineural invasion
My dr indicated that he was going to stop my zytiga treatments on my next visit that will be in a week. I have been having ADT treatments for 24 months now.I would really like to stop the ADT treatments altogether and have seen some information that it might be time to stop. I’ve been suffering with all the usual problems associated with with ADT and would like to try and get my life back
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...I would really like to stop the ADT treatments altogether and have seen some information that it might be time to stop.
I’ve been suffering with all the usual problems associated with with ADT and would like to try and get my life back.
The answer to the first question, you may stop treatment, discuss with your medical team, Increasingly, there is data on "de-intensification" in treating advanced PCa. In the EMBARK trial, rapid responders, those who achieved an undetectable PSA <.02. in the first seven months, were able to come off treatment.
The follow on questions to that are:
Will my T recover. if so, how fast and to what levels?
If my T, recovers, will my PCa also return?
The answers, depends. As others have indicated, factors such as age, baseline T, health, which agents, health...are factors. Your T may recover, it may take time, 6-24 months or longer, it may not.
How long would your "vacation" be? Nobody knows. I share my experience, after 18 months of Lupron as part of triplet therapy mine lasted just shy of five years. After 12 months of Orgovyx we're at 27 months, next labs in October. In both cases, T recovered to 100+ min the first three months, 400+ by six.
If you do "de-intensification," have a plan with your medical team to check T, PSA - frequency of labs, consults...You may want to discuss with your medical team the possibility of TRT should your T not recover. You and they would need to decide what constitutes "not recover." We generally say T <300 is "low." But, in some men, that can take 12 months or longer to reach, so, ae you going to ask for TRT before that?
The answer to your 2nd question resides in the recovery and rate of recovery of your T after coming off systemic therapy.
Kevin