1. < Prostate Cancer

6 months or 18-24 months ADT with salvage Radiotherapy

Posted by rad62 @rad62, Mar 8, 2023

After RARP in 2019 my psa is back up to 0.26 from 0.02 post op.
After PET/PSMA scan right common illiac node showed possible tumor infiltration (SUV-1.9)
I have now decided that the best treatment option for me due to high risk pathology is Radiotherapy combined with ADT.
My question is now, 6 months or 18-24 months ADT.
Research i have found seems to suggest 6 months maybe long enough and give better return to normal testosterone levels and life quality in comparison to 18-24 months.
My radio oncologist is pushing me for 24 months but i am not convinced there are benefits over 6 months.
Would be very helpful to hear peoples experiences in regards to this subject and any links with latest studies e.t.c.
thanks.

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billyh | @billyh | Mar 9, 2023

Thank you so much for this information.
Did you ever receive radiation? What is your tumor grade, if you are willing to share?
We live in Vegas and our urologist here referred us to USC. We have only been there for the RP, no other consults. We are anxious to move forward.
His PSMA scan pre-op was negative however there was seminal vesicles invasion on surgical pathology. No lymph node involvement.
My husband has had little, if any, side effects from his ADT….thankfully.

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gkm | @gkm | Mar 9, 2023

I had a RP in April, 2018 after being on Active Surveillance for 2 years. The surgery was deemed a success and my first two PSA's were undetectable

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vjlvpjalways | @vjlvpjalways | Mar 10, 2023
In reply to @hbp "I am being aggressively treated at UCLA for Gleason 9 PC that had only spread to..." + (show)
@hbp

I am being aggressively treated at UCLA for Gleason 9 PC that had only spread to the seminal vesicles, had RP, was on lupron and Erleada for 13 months. I personally am in favor of aggressive treatment and the side effects of the treatment so far have been manageable. I am 75 and I am hoping to be around for another 10 years. I have recently retired and I worked long and hard to get to retirement. I feel that retirement is the dividend to my years of work. I want to enjoy this dividend and not lose it to this damn cancer. So I always opt for aggressive treatment and aggressive frequent testing given by my UCLA doctors while being mindful of the reasonable quality of life issue. My quality of life is less than pre cancer, but still damn good.

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68 Gleason 9 contained at PR with 90day going up..treatment ADT 2years 39radiation treatments.. side effects minimal

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rad62 | @rad62 | Mar 10, 2023

With all the comments that have been posted regarding the 6 months or more of ADT debate, I am curious to know if the radiotherapy you all received was imrt or did any receive proton therapy ? I was recommended by one hospital proton therapy and another suggested that photon (imrt) has greatly improved and is the standard care.
I would also like to say this forum and it's contribution to helping the prostate cancer community is incredibly helpful and an extremely valuable resource of information.

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1 reply
billyh | @billyh | Mar 10, 2023
In reply to @hbp "BillyH. My aggressive treatment is part of a clinical trial at UCLA medical school and hospital...." + (show)
@hbp

BillyH. My aggressive treatment is part of a clinical trial at UCLA medical school and hospital. I had 6 months of ADT ( lupron ) and Erleada, then 1 month break when I had RP, then 6 more months of Lupron and Erleada. Now they monitor my PSA every 3 Months and they are taking a pet scan in the first 3 month monitor period. 13 months after the ADT, Erleada and RP my PSA was .01 and testaterom (sp) was also very low. If my PSA or pet scan results create a concern, I suspect that they will put me back on ADT and Erleada, which I tolerated satisfactorily.

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Did you ever receive any type of radiation? What is your tumor stage?

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hbp | @hbp | Mar 10, 2023

BillyH. UCLA doctors recommended to me that I have a RP and leave the option of Radiation for later if and when the cancer returns. If I started with radiation,I may have limited my future options.
I have a Gleason 9, advanced, aggressive , Castration resistant, stage 3C PC, so they tell me. The RP did initially left me incontinent but that quickly resolved. A BM has been a little difficult but that is getting better. My surgeon said that he went wide and may have cut a nerve. Good luck to you and all of us on this site.

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1 reply
samidh | @samidh | Mar 11, 2023
In reply to @rad62 "With all the comments that have been posted regarding the 6 months or more of ADT..." + (show)
@rad62

With all the comments that have been posted regarding the 6 months or more of ADT debate, I am curious to know if the radiotherapy you all received was imrt or did any receive proton therapy ? I was recommended by one hospital proton therapy and another suggested that photon (imrt) has greatly improved and is the standard care.
I would also like to say this forum and it's contribution to helping the prostate cancer community is incredibly helpful and an extremely valuable resource of information.

Jump to this post

I received Tomotherapy (which is a type of IGRT IMRT)

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melcanada | @melcanada | Mar 16, 2023
In reply to @hbp "BillyH. UCLA doctors recommended to me that I have a RP and leave the option of..." + (show)
@hbp

BillyH. UCLA doctors recommended to me that I have a RP and leave the option of Radiation for later if and when the cancer returns. If I started with radiation,I may have limited my future options.
I have a Gleason 9, advanced, aggressive , Castration resistant, stage 3C PC, so they tell me. The RP did initially left me incontinent but that quickly resolved. A BM has been a little difficult but that is getting better. My surgeon said that he went wide and may have cut a nerve. Good luck to you and all of us on this site.

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Ask if you should go on Zolodex to stop testosterones the fertilizer of PC

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hbp | @hbp | Mar 16, 2023

I am presently off of all PC drugs and I am being closely monitored by my UCLA doctors We are all hoping that the RP, ADT and erleada might be a cure. I understand that Zoladex is similar to lupron and is a palative medicine and presently that is not for me Thank you for your suggestion

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michaelcharles | @michaelcharles | Mar 17, 2023

Currently on ADT 4 mos Orgovyx together with 37 IMRT radiation treatments to entire pelvic (WPRT) and 25 to pelvic lymph nodes.
This is first (?) round of tx for BCR.
Would not be surprised if ADT extended to total of 6 mos.
RP Aug; Gleason 9 and EPE (all else good).
90 day PSA 0.19 (disappointing).
Prayers for all.

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