Gleason 7 (4+3) radiation, but ADT also? Over treatment?

Might be an idea to get your guy to read the two recent reports I cited earlier in this thread clearly questioning the marginal difference made by ADT over modern radiation. Maybe he already knows them. My guy did not.

As you suggest, its something of a lottery.

David

Thank you Jeffmarc for your comments. Dr Amar Kishan when he treated me with SBRT in April, he suggested ADT for 1 year. I asked him what if I don't take ADT. He said my cancer coming back is 50%. ADT cuts it down by 50%. That means there is 25% chance that cancer coming back!
When I told him that Dr Schulz said that I can stop ADT now, he said it is ok!
It is all probabilistic, nothing definitive for sure!

I understand your desire to continue taking the drug because your PSA continues to drop. Your PSA however, is very low, And that is why Doctor Scholz Said you could stop Orgovyx. Taking the drug for another three months is no big deal, your testosterone will probably come back just as quickly with that small addition of time.

A lot of people don’t get the ultra sensitive PSA test so for them being < .1 For nine months would be enough for some people to say drop the drug And see what happens.

I’m sure you’ve Read other comments about this, discussing the fact that you should get PSA tests no less than every three months when you do drop ADT. Wish you the best with your treatment decision, Hopefully it will give you years without recurrence.

Jeffmac,
I started computer programming as a student at University of Michigan in 1961. Later, I wrote operating systems software and compilers for Burrows machines. Finally retired as a Data center manager at County of Los Angeles in 2005.
Dr. Schulz suggested that I should take a holiday now from Orgovyx. But, my computer mind tells me that I should continue until my PSA reaches a plateau or at least 12 months whichever comes first. just finished 9 months.
My reasoning is if PSA dropping means treatment is working, so why stop the medicine. My quality of life with hormone therapy is not great but certainly acceptable that I can live with it rest of my life if I have to!
My PSA on October 7th was 0.05. I am hoping it will keep dropping some more in the next 3 months.

I feel sure that most forum members will be aware of the PCRI in Los Angeles. Run by Dr Mark Scholz and team it is a mine of information. Their You Tube page 'Alex Scholz' has masses of highly relevant videos and this one is no exception and seems to relate well to this discussion............

'Intermediate-Risk: Do You Need Hormone Therapy With Radiation?"

David

Completely respect your view. However, age and co-morbity is a factor here. I shall be 80 in August and that for me is key. Recent research has shown that side effects ( let alone double side effects from combined treatment ) added to comorbidity issues and existing conditions have an added effect at this age. For instance, key side effects of ADT including bone and muscle loss (fractures/falls), memory loss/cognitive issues, cardio-vascular problems ( I have controlled high blood pressure) all exacerbate likely pre-existing age-related problems. Advances in modern radiation accuracy and dose escalation have narrowed the margin of improvement conferred by ADT and at this age raise questions of balance relating to quality of life. Recent research bears this out. I am prevented from posting links as a new subscriber but do have a search for:-
'Risk of Death in Octogenarians with Intermediate Risk Prostate Cancer Who are Treated with Radiation Therapy (RT) Plus Androgen Therapy (ADT) Versus Radiation Alone, and NCBD Analysis ( Vol.20 - Issue 2, Supplementr E526-527, October 01, 2024.

'Dose-Escalated Radiotherapy Alone or in Combination With Short-Term Androgen Deprivation for Intermediate-Risk Prostate Cancer:

Results of a Phase 111 Multi-Institutional Trial' - Journal of Clinical Oncology

April 27, 2020

Regards,

David

I would have done the same thing that you did, heavyphil. Six months of ADT is a small price to pay for the extra assurance. Now, if the doctor had said 18 months, I would have said, no. I think the longest I'd want to be on ADT—even if I had aggressive pc—is nine to 12 months to preserve long-term quality of life.

I'm no doctor, but I've listened to experts discuss this topic. The general consensus was that four to six months of ADT is generally very tolerable for most people, and those patients typically return to normal afterward without any significant long-term effects. A patient who'd been on ADT for two years told me that patients can generally return back to normal if they undergo ADT for a year or less. But if patients are on ADT for 18 months or more, the ADT-related harm can be very long-term. So the length of time matters. 90 days isn't long at all. I haven't heard of anybody being prescribed ADT for that short time frame. Usually, the minimum amount of time for ADT in the U.S. is four months. Bonne chance!

50 years in computers, 25 working for others doing programming in over 10 languages mostly on IBM main frames, wrote a lot of machine language code. Then I started my own consulting business and had around 100 clients, 26 architect offices. Always a challenge installing new servers and resolving network and software/hardware issues.

Prostate Cancer is just another challenge, just wish I had more control over it.

Well, if it’s ONLY 15 years then it’s really nothing special…😂….haha!
Your attitude has a lot to do with how you come to grips with any illness in my opinion; but even
more, the actual ‘way’ your mind works can’t be underestimated.
I think you mentioned in one post that you did work with computers - and probably software and programming and troubleshooting? Well it takes a very analytical mindset to do that and even though all of us have this quality to some extent, computer people have that Yes/No ‘flow chart’ mentality that they taught us in Computers 101 in high school: If not A, then B….and if B, then C or D….
I think this logical next step reasoning is very important and it frees you from becoming so emotionally worked up that panic, helplessness snd despair soon take over and you start to drown.
Having prostate cancer can be a real rollercoaster both physically and emotionally so it always helps to have someone with a cool head help you get through it.
Phil