How long before relapse occurs or ADT fails?

Posted by wellness100 @wellness100, Jul 22, 2023

There seems different studies/opinions regarding how long treatment of high risk PC last without surgery lasts. In cases with radiotherapy, or without, with chemo or without, a with both first and second generation ADT. Some seem to suggest as little as 2-3 years, others as long as 10 years or more. The deciding factor seems to be the PSA level reached on first treatment. Those who go below 0.2 or even 0.1 seems to do better than those who remain above 0.2.
Does anyone have any opinion to share, or any from their medical team?
Please join in the discussion. Any link would be useful and appreciated.

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I am in a clinical trial for Erleada and ADT at UCLA and have been so for 20 months. Gleason 9 CR, aggressive and advanced76 years. The trial evidence is that I can reasonably expect EFS ( event free survival ) for 41 months with survival thereafter of 2 years and additional meds during that time . I am hoping to beat the stats but the stats are instructive.

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My research on this is all over the place. Seems to be very subjective...i.e. too many variables. Also a lot of different types and ways of going about ADT. I have different doc's with different viewpoints. There are a ton of case studies out there, If I need to go back on ADT, like to try Zytiga 6 months on and 6 months off. This way I stretch out the effect, before becoming resistant. Zytiga works by binding to the cancer cell ,starving it of Testosterone. Hopefully preventing spread.

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my husband has concerns about lupron and albitarone and prednisone.
he has 44 radiation treatment
shouldnt that be enough with psa .1
he feels awful no energy etc.
why more treatment?

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@philipbrachko

My research on this is all over the place. Seems to be very subjective...i.e. too many variables. Also a lot of different types and ways of going about ADT. I have different doc's with different viewpoints. There are a ton of case studies out there, If I need to go back on ADT, like to try Zytiga 6 months on and 6 months off. This way I stretch out the effect, before becoming resistant. Zytiga works by binding to the cancer cell ,starving it of Testosterone. Hopefully preventing spread.

Jump to this post

zytiga is it oral or injection
how is ur fatigue

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@philipbrachko

My research on this is all over the place. Seems to be very subjective...i.e. too many variables. Also a lot of different types and ways of going about ADT. I have different doc's with different viewpoints. There are a ton of case studies out there, If I need to go back on ADT, like to try Zytiga 6 months on and 6 months off. This way I stretch out the effect, before becoming resistant. Zytiga works by binding to the cancer cell ,starving it of Testosterone. Hopefully preventing spread.

Jump to this post

Thanks for both replies above. I come to more or less the same conclusion from scanning the webs. The majority seems to be 5+ years old and counting. Most docs do not seem to want to stick heads out, for understandable reasons. Those who do, with the ones such as Dr. Scholz tend to provide low numbers, for understandable reasons.
One issue is they quote the clinical studies. The small print in these studies is their cut off point is PSA 0.5. But from some rare studies, and for practitioners such as Dr. Scholz,, their cut of is PSA 0.2. < 0.2 the survival rate for 5 and 10 year are about 85%.
It appears, and Dr. Scholz does articulate that, the outcome for those below 0.2 is very different. For under 0.1, Dr. Scholz's experience or opinion is more like 10 years.
So there seems to be a gap, and a fairly big gap .

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@komurph

my husband has concerns about lupron and albitarone and prednisone.
he has 44 radiation treatment
shouldnt that be enough with psa .1
he feels awful no energy etc.
why more treatment?

Jump to this post

44 is a lot so if psa at .1, I think you should watch it and if it bumps up any, more shots of Lupron. I am on it and yes, side effects but beats being under ground looking up. My surgery is Aug. 3rd to take the little bastard out, and on Lupron now. So sorry but keep fighting and enjoy every moment of life. God is great. Pray now. It works either he lives or goes to heaven. We all die but all want to live as long as we can. I am a strong Christian and God does take my anxiety away.

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@wellness100

Thanks for both replies above. I come to more or less the same conclusion from scanning the webs. The majority seems to be 5+ years old and counting. Most docs do not seem to want to stick heads out, for understandable reasons. Those who do, with the ones such as Dr. Scholz tend to provide low numbers, for understandable reasons.
One issue is they quote the clinical studies. The small print in these studies is their cut off point is PSA 0.5. But from some rare studies, and for practitioners such as Dr. Scholz,, their cut of is PSA 0.2. < 0.2 the survival rate for 5 and 10 year are about 85%.
It appears, and Dr. Scholz does articulate that, the outcome for those below 0.2 is very different. For under 0.1, Dr. Scholz's experience or opinion is more like 10 years.
So there seems to be a gap, and a fairly big gap .

Jump to this post

I'm confident that in 5 or 10 years they will have new and better methods of treatment.

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@komurph

zytiga is it oral or injection
how is ur fatigue

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Zytiga is pills, the generic abireatone is cheaper and can be lower with a coupon from Qrx. Managed my fatigue with coffee and aerobic exercise. A lot of it is mental. As your doc about a script for zoloft.

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Prostate Cancer Foundation (PCF.org) webinar replay of
Jan 17, 2023 program (2 part video or transcript) discussion on rising PSA after surgery/radiation.
I watched it yesterday and found it very informative.

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@komurph

zytiga is it oral or injection
how is ur fatigue

Jump to this post

Zytiga is 4 pills a day, not bad at all, but strength is off 50% or more.

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