1. < Prostate Cancer

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

Posted by zooblio6 @zooblio6, Dec 26, 2024

Hello,

I will be 80 next August and apart from newly diagnosed PC am in good overall health. I have a diagnosis of Gleason 7 (4+3) Grade 3, T2a with a five year PSA of 0.6. Six cores positive in the recent biopsy. No spread to the bones or organs as indicated by CT scans etc. I see my urologist on 7th January and am concerned that he will propose ADT in addition to the inevitable RT ( I suspect IRMT ).

The side effects concern me ( although I already have erectile dysfunction ) mostly those concern possible memory loss, bone and muscle loss and cardiovascular risk ( I have controlled high blood pressure ).

I have read several recent reports that indicate that ADT may represent overtreatment in older patients and the more so where the cancer grows more slowly. Quality of life is key for me and my wife.

Can anyone please give a measured/qualified overview please. Thank you.

David

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heavyphil | @heavyphil | Dec 27, 2024
In reply to @zooblio6 "Hi Jeffmarc, Thanks for your reply. That is quite some time to be on the ADT,..." + (show)
@zooblio6

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

Jump to this post

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

REPLY
1 reply
zooblio6 | @zooblio6 | Dec 27, 2024
In reply to @jeffmarc "I was on Lupron for 7 years and Orgovyx for 1. Yes I have some brain..." + (show)
@jeffmarc

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.

Jump to this post

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

REPLY
2 replies
zooblio6 | @zooblio6 | Dec 27, 2024
In reply to @hbp "I was on luprone ADT and Erleada for 13 months and the RP for G9 ADT..." + (show)
@hbp

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.

Jump to this post

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

REPLY
jeffmarc | @jeffmarc | Dec 26, 2024

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.

REPLY
1 reply
hbp | @hbp | Dec 26, 2024

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.

REPLY
1 reply
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