Gleason 7 (4+3) RT but ADT also??

I was on luprone ADT and Erleada for 13 months and the RP for G9 ADT mostly affected my sleep but it was otherwise ok and it kept me alive. That was when I was 74 now 78 and doing good. It is medicine that you need to keep you going and that is the ultimate goal.

I was on Lupron for 7 years and Orgovyx for 1. Yes I have some brain fog, people rarely notice. Yes, it deteriorated my muscles so I walk the track, across the street, twice a day and go to the gym for an hour 3 times a week. I let my muscles go for 6 years and after 4 months my muscles have been coming back. Make sure to exercise regularly. I am 77 doing this and my testosterone is 7.

I had cardiac issues when I started Zytiga after being on Lupron for 4 years, never had an issue with Lupron alone. I know cardiac issues are possible but after years of weekly advanced prostate cancer meetings I do not recall anyone mention it.

Fatigue can be a problem, for some it is a real problem. You probably would only have this issue for 6 months.

With a Gleason of 7 they usually recommend ADT for 6 months. That reduces reoccurrence.

IMRT combined with SBRT to the prostate reduces the number of IMRT sessions. Done frequently. Something to think about. There are many other treatments like HIFU, cryotherapy, TULSA-PRO or more.

Thanks for that hbp - encouraging that you seemed not to have suffered any bad side effects from ADT. Thanks for your reply.

Hi Jeffmarc,

Thanks for your reply. That is quite some time to be on the ADT, so I guess some side effects must be expected. The brain fog is on that I least like the sounbd of in that I am a musician and really do not need problems remembering materials.
Encouraging that your muscle is returning. I am starting with weights now befoire the treatment is decided on 7/7 since I feel sure I have lost a certain amount over the past 15 or so years. Finally, I worry at my age about potential bone loss. Thanks once again, David

You probably only need 6 months of ADT - if at all. Don’t even worry about all those feared side effects in that short a time period.
You’ll have some hot flashes and not much more if you exercise regularly and watch your diet. Best

I'm 60 and had pretty much the same diagnosis as you. I did SBRT (accelerated RT) and six months of ADT. I started with Lupron but had very bad mental side effects (depression, suicidal thoughts, forgetting names of people I'd known for years) so I switched to Orgovyx after two monthly Lupron injections and it was a lot better. It also has worn off much faster. I'm two months out from it now and feel no more effects from it while people in my support group who are on Lupron say it takes 3-6 months to return to normal after stopping.

If you are going to do ADT, I would suggest either Orgovyx (daily pill) or a MONTHLY injectable vs. the 3 or 6 month injectables because that way, if the side effects are too much for you, you can stop or switch to something else.

Note that only a couple other guys in my group got the same side effects as me. Others got physical side effects like hot flashes which I didn't get. So it seems everyone's side effects vary somewhat.

David, I had similar diagnosis as yours (4+3) three years ago at age 74. Urologist and radiologist both were insistent on ADT. I also had no spread and cancer was limited to prostate.
I decided to have proton therapy only due to all the potential effects of ADT. My logic was largely based on protecting my current quality of life at my " young age" with the understanding that there could be some additional risk of a recurrence in later life. A roll of the dice , no doubt, but three years later all looks good so far.
Not endorsing my decision for anyone else but only for me. Best, Ron

Did anyone have low RBCe and have to stop treatments?

I saw a recent webinar where this doctor was discussing bone health when on prostate cancer drugs like ADT.

He said that everyone should have bone strengtheners. He showed how the drugs affected the bones if they were not on strengtheners.

I was on Fosamax for at least five years and I’m now getting Zometa infusions. Another major bone straightener is Xgeva. Both Zometa and Xgeva have a risk of causing osteonecrsis (severe jaw bone problems), but a very small percentage are affected, more with Xgeva than Zometa, but Xgeva is supposed to be a little More effective.

Ask your doctor about putting you on one of these strengtheners. If he doesn’t put you on ADT, it’s not really that Important. If he does put you on it, for only six months, you want to ask him if you should have it?

Thanks again, I am coming to that view. Not sure my urologist will agree, but at this age, quality of life is important. For instance, as a musician I would find memory issues a bummer. Thanks again.

David