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What is the current position on the length of hormone treatment?
Prostate Cancer | Last Active: Jan 7 9:31am | Replies (46)Comment receiving replies
Thank you retireddoc your post was very helpful to me. I am a retired lawyer and in my practice about 30% of my clients were physicians ( real estate, business and estate planning). I always liked dealing with doctors in such matters and I miss it. I was diagnosed 30 months ago at 74, Gleason 9 , CR, advanced had RP and 13 months of ADT and Erleada. I did not know about the triple therapy then and it was not offered to me. I am presently good, undetectable PSA and low T and off of meds for a year now, but I have been advised that the PSA will probably rise this year and at that time I will chat with my doctors about a triple therapy plus radiation. 30 months ago I was advised that I had 4-5 years and I am doing all that I can to up that prognosis. Your history of triple therapy plus radiation is helpful.
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Just a follow up to your reply. I asked my MO at JH and his very experienced NP (Dr. Pienta and Diana Reyes NP) what the next steps would be. They said that from their experience treating men in a subgroup like me (high grade cancer G9, very limited spread, excellent response to initial triple therapy with undetectable PSA) that about 70% remain undetectable after about 3 years (I don't think they have reliable data further out) and 30% will see PSA rise as testosterone rises. If PSA goes up they will wait until it hits 0.5 and then repeat the PSMA PET. If the PET shows another site of spread they will use SBRT to obliterate the cancer +/_ short 3 month course of Lupron.
I don't believe there are set-in-stone protocols for men in my position at this time due to the rapid evolution of treatment and the large number of trials ongoing. For me, that is why I went to someone with extensive experience, heavily involved in research, treats almost exclusively prostate cancer, and treats patients individually based on their circumstances rather than following set protocols (Standard of Care-which lags the curve of latest trials etc).