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Considering stopping Eligard after first injection and radiation.
My special friend is considering stopping ADT after the first injection (6 months) and radiation treatment. Has anyone made this decision, and what are the results? His PSA went from 9 prior to treatment to less than .1. I have read about the possibility of stopping and keeping a close eye on the PSA. If there is a significant rise, starting the Eligard again. He also has an autoimmune condition that causes him a great deal of pain, and the combination has been difficult. I realize that a minimum of 18 months on the ADT is protocol.
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I am sorry to hear about the pain and the challenges of the autoimmune condition. Ultimately the quality and quantity of life is a very difficult optimization problem and the pain must be considered dearly in making these decisions.
My understanding is that an "ADT Holiday" or "Intermittent ADT" is something that can be deployed after completing the initial treatment of ADT. I am not sure if 6 months is the standard of care timeline, my recollection is 18-24 months is more of what I've heard (I'm on month 18 and aiming for 24 months to finish my initial treatment).
Has your friend has surgery or just radiation? To some extent, this does matter as it will indicate where the cancer is in the body and what action can be taken if/when the PSA rises again.
Keep the faith, your friend is dealing with a tough situation and glad you are there to help
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3 ReactionsOn the subject of adt holiday. Just completed mri and petscan with undetectable psa. Scan results clear.The scan results accuracy is questionable due to negligible psa. Does anyone think an adt holiday and the likely rise in psa would reveal targets for precision proton therapy as an alternative to catpetbombing my pelvic region healthy tissue and all with photon therapy?
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1 ReactionI would ask my team about this. I had high dose Proton radiation and received a total of 3 shots. Two of Firmagon and one Eligard. This was in Feb/March of last year, then received my radiation in May. Other than the side effects, my Doctors are happy with where I’m at. Stay strong Brother.
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1 ReactionGreat news on the current condition!
To your question, I reviewed this exact question with my health team in early April and here is what I can share. My biochemical recurrence was in 20+ lymph nodes so radiation wasn't an option so I went the ADT route. When I get off of ADT we will monitor the PSA. Option 1: If the PSA rises to like 0.2, 0.4, 0.7 and so forth, it is likely we will do a PSMA PET scan and if there are a few spots that are lighting up on the scan, we may opt to use radiation. Option 2: If the PSA comes back at 5 and continues higher, we will likely just go back to ADT, but might do a PSMA PET scan to see the situation, but the team is fairly confident that a 3-month rise into single or double digits will equate to needing to starve the cancer. Time will tell, but will share. Keep the faith.
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2 Reactions@fisch, you got some great responses from @edmond1971 @billfarm and @slick64. I agree that your friend will want to discuss options specific to him with his oncologist, especially given that he has other condition(s) to consider.
You might also direct him to this related discussion:
- Anyone take a Treatment Holiday? Intermittent use of ADT
https://connect.mayoclinic.org/discussion/anyone-take-a-treatment-holiday-intermittent-use-of-adt-like-orgovy/
- When to resume intermittent hormone therapy?
https://connect.mayoclinic.org/discussion/when-to-resume-intermittent-hormone-therapy/
How old is he and what was his Gleason scores. There are studies that show for intermediate prostate cancer that ADT makes not much difference in BCR or overall survival if you are older than 70.