Has anyone done Proton without Hormonal Therapy (ADT)?

Posted by mikewo @mikewo, Mar 29, 2023

Has anyone done the 5 session Proton beam treatment without ADT? Any results?

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For ..., recurrence, if so, to what?

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@kujhawk1978

For ..., recurrence, if so, to what?

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Yes, biochemical reoccurrence, or mestastis and in what time frame. If you are in your 70's and it happens in 20 years it is no big deal. If you are 50 it is. Just asking if anyone has long term data.

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I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

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@gentlemanrancher

I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

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I am also looking at this. I think to modernize it, they could give us a month of LU-177 pluvicto kind of thing instead of ADT (as far as I know this is not offered). In many cases ADT is just above noise in the data if it would help, some people maybe, others maybe or probably not. At least for me I would rather do proton then a short duration LU-177 kind of thing, that over the old tech ADT that only helps a few and hurts a real lot of people.

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@gentlemanrancher

I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

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I pray about everything and I just don't have peace with the OLD hormonal treatments with significant side effects.
Thank you for your input, I haven't studied LU-177 yet.
GOD is in charge... 🙂

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@gentlemanrancher

I pray about everything and I just don't have peace with the OLD hormonal treatments with significant side effects.
Thank you for your input, I haven't studied LU-177 yet.
GOD is in charge... 🙂

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I'm right there with you.

Not important to learn but....
PSMA/Lu-177 won't be available for us just yet as an alternative to ADT, maybe in ten years, see PCRI discussion on who gets it first (people with mets)
https://www.youtube.com/watch?v=Th42pFOx0Fs

or how PSMA biotechnology works discussed here
https://www.youtube.com/watch?v=JoJomACA5UM

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@gentlemanrancher

I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

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My experience with ADT hormone therapy Orgovyx was not that bad.
BCR after RP led to salvage radiation together with 4 mos Orgovyx.
Different protocols for different Drs/patients, but a 4 - 6 mos ADT course appears common.
I was opposed to ADT until my Rad Onc said adding ADT to my radiation would add 20 percentage points to my possible outcome.
Sold. Did not like it; would do it again. In for a penny: in for a pound. I'm trying to put this evil thing into deep sleep.

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@gentlemanrancher

I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

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I had proton without ADT. I was an otherwise healthy, very active 74 year old who did not want some of my last good years potentially ruined by ADT. If my life expectancy was shortened somewhat but quality was increased, count me in. One of the radiologist that I consulted with estimated that while deleting ADT might result in a 20% worse outcome, perhaps a 15% better outcome would occur from avoiding all the other health impairments that could occur from ADT. One of the specific considerations for me was the amount of dementia in my family on my fathers side. It is important to state that this radiologist estimate was for my specific case and personal considerations!
I did all the recommended things( bone scan, mri, PSMA pet, decipher and pathology second opinion) as well as consulted with urology oncologist, photon radiologist and two proton radiologists. My Gleason was 4+3 (2 cores) and 3+4. ( 3 cores) out of 10 samples. My PSA was 8.9. Post-treatment PSA was 2.9, 2.3,4.9 ( spike that happens sometimes) and 1.7. I completed proton treatments a little over a year ago so only time will tell if this was the right decision but you make the best decision for you and don't look back.

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@bandit11

I had proton without ADT. I was an otherwise healthy, very active 74 year old who did not want some of my last good years potentially ruined by ADT. If my life expectancy was shortened somewhat but quality was increased, count me in. One of the radiologist that I consulted with estimated that while deleting ADT might result in a 20% worse outcome, perhaps a 15% better outcome would occur from avoiding all the other health impairments that could occur from ADT. One of the specific considerations for me was the amount of dementia in my family on my fathers side. It is important to state that this radiologist estimate was for my specific case and personal considerations!
I did all the recommended things( bone scan, mri, PSMA pet, decipher and pathology second opinion) as well as consulted with urology oncologist, photon radiologist and two proton radiologists. My Gleason was 4+3 (2 cores) and 3+4. ( 3 cores) out of 10 samples. My PSA was 8.9. Post-treatment PSA was 2.9, 2.3,4.9 ( spike that happens sometimes) and 1.7. I completed proton treatments a little over a year ago so only time will tell if this was the right decision but you make the best decision for you and don't look back.

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I like that mentioning better outcomes by skipping, it is only fair. I have brought up a half dozen papers on ADT and stats are not me field but I can say one thing they never mention is deaths from obesity, or deaths from brittle bones and you fall down steps and need hip replacement and stroke out during surgery. All that is missed in every paper that I looked at. Plus stats is a field where differing stat methods show differing outcomes too because separating real results from noise is not so trivial sometimes, though papers are peer reviewed in all journals doesn't mean multiple methods were run to be sure.

Of course if your testosterone is on the moon high then ADT might be handled well and just brought down a bit during ADT then it comes back up, but most of us are not teenagers last time I checked.

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@gentlemanrancher

I keep reading about the horrible side effects of Hormonal Therapy and it seems it destroys quality of life, increases weight 10%, messes with bone, lose hair, increases pain, messes with emotions etc...
I'd appreciate hearing opinions from anyone who has chosen this path.
One Doc in Ca. suggested just doing it for a couple months...

Jump to this post

I'm 73 ,been on ADT, Zytiga 6 months and Eligard for a year, my side effects were minimal. Loss of strength and muscle, and ED. Some brain fog setting in the last 2 months. Continued to workout, do breathe work, meditate . I was ok with the side effects, because of the great results, PSA < 0.04 for the last 10 months, and everything has shrunk down to normal size, having RALP next week.

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