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ADT how long post Radical Prostatectomy & Radiation Therapy?
I'd like to know how long men have been on Lupron after a radical prostatectomy and adjuvant radiation. I've been told that I should be on Lupron for anywhere from 18 months to three years after my surgery, or two years if having radiation after surgery. My surgery was May 1, 2019, and I'm currently receiving 34 radiation treatments. I'd like to get off of Lupron as soon as possible after radiation, but I don't want to cut it short if there is a benefit to a longer Lupron treatment.
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My SRT was to the prostate bed, the subsequent 25 IMRT were to the pelvic lymph nodes.
My radiation oncologist says that if or when it reoccurs again, radiation treatment is possible, depends on where the reoccurrence is.
As a rule, my medical team avoids generalizations with me, rather we talk in specifics to my clinical data, not population based medicine.
Oh. I’m doing wprt
My psa started to rise 3 yrs after rp. To .28. Currently doing 36 srt and 3 months adt w orogovyx. Anyone think 3 months is too short. Psa now undetectable and tes at 42.
Some of the answer to your question may lie in your pathology report - Gleason score, margins, seminal vesicles, ECE...if your PSA dropped to undetectable after surgery, and margins, SV and ECE were negative and BCR three years later then you may benefit from SRT and short term ADT. Short term generally is six months, not three. If you have multiple high risk factors - GS 8-10, your margins, SV or ECE were positive, your PSADT <12 months then 18-24 may be necessary. Also, did you have any imagining such as the Aximun or PSMA? Did you and your medical team discuss whether or not gto include the pelvic lymph nodes in your treatment?
Gleason 7 4/3. One lymph node involved, ECE. No pelvic lymph involved. Psa undetectable for 3 years. Aximum negative. We are doing the bed and pelvic lymph now.
I had RP in March 2014, BCR in September 15, SRT in March 2016. Then six cycles of taxotere, 28 months of Lupron and 25 more radiation treatments to the PLNs after a C11 Choline scan showed four PLNs though no bone or organ.
When I did SRT the idea of adding short term ADT snd including the PLNs was not well received in clinical practice. SRT failed and my PSA continued to climb rapidly, doubling time was <3 months.
The original plan was 24 months of Lupron but we stopped at 18 based on how well I responded. It’s been three years I finished and none since.
Given what you described, 6-18 months of ADT may be needed.
Have you had a biopsy
Here's two articlse which may be useful - https://www.urotoday.com/conference-highlights/esmo-2022/esmo-2022-prostate-cancer/139430-esmo-2022-duration-of-androgen-suppression-with-post-operative-radiotherapy-dadsport-a-collaborative-meta-analysis-of-aggregate-data.html
https://www.urotoday.com/conference-highlights/esmo-2022/esmo-2022-prostate-cancer/139510-esmo-2022-lba9-duration-of-androgen-deprivation-therapy-with-post-operative-radiotherapy-for-prostate-cancer-first-results-of-the-radicals-hd-trial-isrctn40814031.htmlKevin
After radiation I was on Zolodex for a year , then they took me off it Two years later cancer metastases to my spine L2 Lumbar
My PSA went to 25 after 4 years since 40 days of radiation Lots of scans and MRI's Put me back on Zolodex which stops testosterones that feed PC cells and psa now 1.2 stable for a year, 5 years ago I sent my blood to 4kscoretest in NY $600 and that said I had aggressive cancer, It was aggressive, See web site. Now after 5 years since radiation it metastasized to L2 lumbar bone which I had intensely radiated 2 times taking out 1 inch of cancer on L2. So I am castrate sensitive and ADT is working. That is the end goal ADT after surgery or radiation to be working is my thought, I have friend on Zolodex for 26 years now
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