Lupron Treatment Duration: How long were you on it?

My urologist had me on Lupron immediately following a biopsy, which detected advanced prostate cancer in 2017. It’s been 4 years, with 2 injections in 6 month intervals each year. He retired last year due to the pandemic and his successor recommended immunotherapy. When I asked why the original urologist had not mentioned immunotherapy, he said “… he didn’t do a good job…” When I visited my oncologist, he told me that he was not a fan of immunotherapy and instead put me on enzalutamude, saying it is customary once prostate cancer becomes resistant to Lupron. So, I did not do the immunotherapy, have had targeted radiation to my lower back because of the pain. One of the side effects they didn’t tell me about with Lupron, and that is that it creates muscle loss. I have worked the entire time during my treatments with no other major side effects - until recently. Has anyone had any success with immunotherapy to treat advanced Prostate cancer?

I just received my 2nd 6 mo. Shot and I 'm set up to be on it until Sept of 2024. Total of 2.5 yes.
It's not the worst treatment I'm on.

Has anybody been changed to Eligard inj instead of Lupron? My medical team has started using it instead of Lupron and let me tell you, It is the most painful injection I think I have ever had!

I did two full years of Lupron injections. They ran out of it and gave me Eligard instead. Yes. It was more painful. I believe I got it in the stomach instead of rear-end. I never had immunotherapy. I may get it if it starts spreading. It is in my lymph nodes. I am 76. Cancer was diagnosed when I was 72. The doctors gave me five years. The best way to fight it is thru exercise and diet. So far, it is working. I see my medical oncologist this Thursday and get all my blood tests including PSA and testosterone. My wife and I are working hard on getting an erection. So far, nothing. I do get a feeling that if I am ejaculating, it is going inside.

You're aware of the penile implants that inflate with saline (I think) to provide an erection? PCRI dot org had arecent virtual seminar, "Improving Quality of Life: ED, Incontinence and More" Jeffrey Brady, MD, FACS

Forget sex Testosterone is the fertilizer of Prostate cancer Get on Zolodex injections to get PSA down as it stops testosterone

So does Lupron.

So speaking with my medical oncologist, staying on ADT for 2 years is an arbitrary number. No one knows. I have Mets to my lymph nodes. Did RP and 40 rounds of IMRT.
If I stop at 2 years, I’m playing the waiting game for it to pop up anywhere in my body.
If I continue it indefinitely, I risk becoming castrate resistant.
So confused
Help

This won't help much but, I'm interested in your research here. I think you are basically correct, it's more of a delay tactic than anything else.

From what I've found ADT seems to just starve/weaken the cancer cells so they can't multiply but doesn't actually kill them. My guess is it's believed that weakening the cells this way may make IMRT and other radiation protocols more effective.

If this is correct, then yes the time on ADT does seem arbitrary. My surgeon wants me on ADT for two years but doesn't really give a good reason as to why.

My radiation oncologist seems ambivalent on the subject and tells me ADT only accounts for a 3%-5% better outcome when taken with IMRT. I did see stats that suggest 18 mos to 2 years is 35(ish) % better than 6 mos, but if that only applies to 3%-5% of all patients anyway......?

If all this is true, taking it for two years seems to be for the purpose of letting you have that time with little or no cancer growth, if there is any cancer left. So, are we just postponing the inevitable by taking this? Creating time for better treatments to hopefully come along?

Unless somebody here or on my team convinces me otherwise. I'd rather stop at 18 mos, (seems to be a new common time frame) and see what happens. at least if I'm not resistant, I can go back on it, if the PSA starts to climb. No?

Sorry I couldn't offer more help / info, I'm just going down the same road mentally and I'm interested in others opinions on this as well.
Best of luck to you!

@haft2hunt, I'd like to add my welcome. Your question about length of time of ADT with metastatic prostate cancer is something members often ask about. For this reason, I moved your question to this existing discussion:
- Lupron Treatment Duration: How long were you on it? https://connect.mayoclinic.org/discussion/lupron-treatment-duration/

I did this so you can read through previous posts and connect easily with members like @web265 @rxharleydude @spryguy @craigc @scullrower @melcanada @yell0wsub @ken1946 and many others.

You may also be interested in these related discussions:
- Stage 4 prostate cancer treatment options: https://connect.mayoclinic.org/discussion/stage-4-treatment-options/
- Lupron yeah or Lupron nay that is the question. https://connect.mayoclinic.org/discussion/lupron-yeah-or-lupron-nay-that-is-the-question/
- Metastatic Castration Resistant Prostate Cancer https://connect.mayoclinic.org/discussion/metastatic-castration-resistant-prostate-cancer/
- ADT how long post Radical Prostatectomy & Radiation Therapy? https://connect.mayoclinic.org/discussion/post-radical-prostatectomy-and-adjuvant-radiation-therapy/
- Anyone considered bilateral orchiectomy: Why or why not? https://connect.mayoclinic.org/discussion/bilateral-orchiectomy/

It's such a confusing burden to have to weigh treatment options with so many unknowns.