Androgen deprivation therapy (ADT) for short or long-term?

This is what the newest research showed :
https://www.urotoday.com/video-lectures/advanced-prostate-cancer/video/5413-poseidon-meta-analysis-re-examines-the-role-of-adt-with-salvage-radiation-for-prostate-cancer-amar-kishan.html

You should definitely get a decipher test. You’ve already had a reoccurrence and you want to find out the chance of Reoccurrence in the future. ArteraAI Is similar and your doctor May prefer that.

The question is how well you were doing on ADT? Are you getting a lot of fatigue? I’ve been on a for eight years and I don’t get fatigue so it’s not really a problem for me. Same things happened to some other people You need to figure out what you can handle. After having a reoccurrence so soon you do want to stay on ADT for 24 months if you can.

You should probably be on an ARPI, Darolutamide Has the least side effects you should ask your doctor about adding that. Normally, when somebody fails their prostatectomy so quickly, they will put them on that or one of the other ARPI drugs.

Am i reading the Uro today study recommendation that you don’t need ADT at BCR if treated by .5 PSA.

@jeffmarc
Hi Jeff
Thanks for your comments, my Dr no order the decipher test after prostatectomy. I will ask my doctor about Doruluramide, regards

If it were for primary radiation, with a Gleason 7(4+3), localized prostate cancer and no other risk factors, there would’ve been just 6 months of ADT initially recommended (which is what I had at 65y along with 28 sessions of proton radiation).

In your case, having failed RP, positive margins, elevated PSA, and need for RT, if it were me, I wouldn’t be pulling my punches at this point. I’d hit it hard (but not too hard). I’ve seen so many guys try to soft-pedal it, only for it to come back again.
> what is your PSA Doubling Time?
> with your initial 7(4+3), do you know what % of that was “4”?
> you had a post-surgery PSA of 0.48 ng/mL, what is it now? Your post-surgery PSA of 0.48 ng/mL is so close to that POSEIDON study threshold of 0.50 ng/mL, that I’d err on the side of caution and use the ADT. (Especially since as they point out in that interview, “… patients who have a PSA level of more than 0.5, they likely have metastatic disease.” I wouldn’t mess around with that. I know there’s this hesitancy about ADT, but being so close to that POSEIDON threshold, I’d think twice about this.)

It sounds like even only 4 to 6 months of ADT would be sufficient in such a case. This study is huge as in the past it was 24 months for everybody then maybe 18, then some 12. The concern they state with giving ADT is the long term effects. It is terrific news for patients going forward and also how oncologists have struggled as some began reducing ADT length of time based on anecdotal evidence obtained through networking at cancer conferences regardless of NCCN cancer guidelines

In Jan 2023, I was give a 4 mo tx w/ Orgovyx wrapped around IMRT radiation at JH.
Surgery Aug 2022 for G 9, post-op path confirmed G 9 and found EPE.
I trust my RO, and this was his tx for me. And I had not seen short term ADT indicated for my high risk PCa.
Almost 3 yrs post SRT, my PSA has been undetectable < .02
I can only hope and pray that my treatment results continue, although I anticipate a recurrence sometime in the future based upon the historical data.
Best wishes.

@wheel1
I think you’ll find that the recommendations are based on the extent of cancer in the person. If they have a Gleason 8, 9 or 10 Or have other extreme issues then ADT may be necessary, no matter what the PSA.

Weel11,
Thank youn for your comments, other comments said same 6 months is ok

That is very true and so very beneficial and life saving for those but others regardless of their Gleason were given ADT for extended terms having them endure the for many, difficult side effects which they are acknowledging.