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MRI Seems to indicate Prostate cancer recurrence

Prostate Cancer | Last Active: Sep 7, 2023 | Replies (19)

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@natem

I don't like the fact that they make all these various test results available for the patient to see, before the ordering physician has a chance to review them. I know bits and pieces, enough to make myself look ignorant if I opined. Best wishes for you, hopefully your doctor's been in touch to review by now.

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Replies to "I don't like the fact that they make all these various test results available for the..."

I disagree. I like to know the results so I can prepare for my visit. I suggest to those who do not to simply not look at them.

That's a choice, depending on your patient style, you can choose not to see them and wait until your consult for your medical team to explain them to you...or you can review them and formulate questions for your consult. I'm in the latter category and the medical team I have prefers that I come into our consults informed and ready to engage in discussion.

I just finished a message to my radiologist and oncologist with treatment decisions I wanted to discuss in our October consult along with data from the ARCHES , here it is:

At this point in my treatment plan, the clinical results are exactly what we wanted.

I do not enjoy treatment, the SEs, fatigue, muscle and joint stiffness, hot flashes, challenges with managing my weight..

The Orgovyx, combined with the SBRT are doing exactly what we had as an objective of my treatment plan, T is castrate at < 9, PSA is undetectable at < .04. I expect labs in October will show the same.

Since we are taking this treatment in three month intervals, making a decision at each point, I wonder about adding the ARI and the risk, benefits.

My objective is to gain the longest progression free period off treatment while balancing the risk-benefit of doing so since it may involve adding another drug to the treatment.

So, my questions for our October consult are:

Do we stop treatment at six months and actively monitor?
Do we continue Orgovyx to 12 months?
Do we add an ARI?

While I understand there is no assurance about differences in progression free survival , overall survival...between the three potential treatment decisions... the SEs of adding an ARI, your input as to that decision is key to any decision we make.

The ARCHES trial is intriguing as I think about that decision - https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/144592-the-efficacy-of-enzalutamide-plus-androgen-deprivation-therapy-in-oligometastatic-hormone-sensitive-prostate-cancer-a-post-hoc-analysis-of-arches-beyond-the-abstract.html

As a patient reading various reports, it seems it may meet one of my objectives, a more durable progression free survival. I also realize that this trial combines ADT and an ARI while I have included SBRT so perhaps it is more or less equivalent.

It's a challenge for me to navigate the treatment world of prostate cancer treatment. I look forward to our discussion and decision in October based on your counsel and guidance.

Thanx

Kevin