The problem is how to treat the more advanced levels of the cancer, i.e. Gleason score of 8 or higher. That's when they feel that ADT becomes important. My radiation oncologist told me on my first visit that using Lupron with radiation increases my chance of "survival" by 20%. It brought it up from 60% to 80%, and I didn't have any secondary spread of the cancer. Needless to say that caught my attention. So, my wife and I are willing to live with the issues that come with Lupron.

If you want to explore other options, you could look into new treatments for people who inherit mutations in DNA-repair genes found in advanced prostate cancers. If you go to Practice Update Advanced Prostrate Cancer and look at the video expert opinion section. There's a February 25 interview on Inherited DNA Repair Defects. I don't know if you've had Genome testing, but about 12% of men with advanced prostate cancer can have these defects and can be treated without radiation or surgery. It wasn't a part of any discussion I had with any doctor.

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