Gleason 9: ADT before radiation
I have been on active surveillance since 2016. PSA jumped from 6 to 10 and biopsy Gleason 9. Doc ordered Luperon and radiation. Does it pay to start the Luperon before radiation? I am 83, does ADT work for people my age?
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I have the same concerns as it seems like 18 months to 24 months is just standard for all. I have also read a study that utilized doing ADT for 6months with the radiation treatments, then go off and watch the PSA and then if needed go back on for 6 months and repreat.
web265,
3%-5% is statistically irrelevant so ignore that data.
You won't find that ADT kills cancer cells because it doesn't. ADT reduces testosterone to zilch. Testosterone fuels our prostate cancer thus you remove the fuel from the fire. I was a Gleason 10 so I took everything they threw at me. Yes, Lupron messed me up bad. Walking is difficult. I'm on Physical Therapy now and last week I fell and badly injured my leg which became infected. Just lovely!! If you can avoid Lupron I would give that serious consideration.
I agree. Lupron I feel is given way too often.
I did not have Lupron , but what I did have is a PSA of 10.2 and my radiation oncologist, based on my biopsy, decipher report and my MRI said, although it is part of the recommendation for a PSA over 10, she suggested radiation only. My psa is going down so far to 4.6 now after completing radiation in February. I personally have a real hard time with the concepts of Monitoring as their does not seem to be any real science behind how fast something can grow in the prostate and beyond so I wanted whatever I had out and treated right away. I am 70.
What was your pathology report from Prostatectomy?
I meant report from biopsy?
At a Gleason 9, pathology from prostatectomy contained🙏I opted for throwing the sink at it Lupron 1-2years and 39radiation tx. At prostatectomy PSA highest 5.6.. 1x reading
I had 3+4 grade group 2 as my highest Gleason. T1c. My decipher test showed a .9% 5 yr risk of metastasis and a 2.2% 10 yr. The myrisk hereditary test showed no variance of uncertain significance, so that part I did not have to worry about my son or daughter. My brother had radiation and adt and he had a 6.5 psa. I did not have my prostate removed, although it was a choice. I had MRIDIAn linac radiation only.
Just curious, with your approach was the intention to cure or active surveillance?
I've been trying to find criteria to decide when to stop Lupron. I'm finishing 12 months, and wondering whether the side effects of Lupron are justified by the claimed improved outcomes. Myself, I've found them devastating.
I've asked my oncologist three different times the following question: at some time, someone must have compared PCA patients treated with Lupron versus those who were not. How did the two groups compare? In other words, what percent had outcomes improved by Lupron. He has always elided the question (e.g. "everyone benefits"). It must have some valued benefits for many patients. I would like know the frequency and decide for myself what risks I am taking by dropping this therapy. As of now, I feel like a dead man walking.
I would like to have some detail on a claim of 3-5 % improvement. Surely that cannot mean 95% show no improvement in outcomes. Do you know more?
Can anyone clarify this, or explain my oncologist's non -answer?