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

I had salvage radiation and no ADT. Took 2.5 years to come back, and I have BRCA2. Then I started ADT.

Thanks Jeff ,
I am a Prostate Cancer Advocate . I am pretty much up to date on the International Current & Emerging Treatments , many of which have been slow on the uptake by the FDA .
I plan to avoid ADT at all costs if possible . Sometimes the cure is worse than the disease . I have personal experience watching both my brothers-in-law . They were dignosed at stage 4 -- Both passed inside 2 years .
Ages 89 AND 86 . Both had listened to the BS theory : " You will die with cancer - Not from it" and had stopped getting their PSA .

So perhaps the addition of ADT earlier might have made a difference? But I think you’ve pointed out that the BRCA2 problem might have even eclipsed ADT and caused the cancer to come back anyway.
I guess today you would have gotten the triplet therapy regimen - that’s ADT combo plus chemo?
Still amazing to me that you have beaten this thing back for 17 years and are still standing strong….Happy New Year, Jeff, and thank you once again for all your help, knowledge and support!
Phil

Thanks for your comments and I will ask about the decipher score which has not been mentioned to me by my care team.
Happy New Year to you as well!

It really is 15 years not 17. I never had metastasis in the first eight years, So I don’t think chemo would’ve been in the picture even if they knew I had BRCA2. Only one Metastasis on the spine (L4) so far. Waiting for the pin to drop!!!

People are SO different in how their bodies react to PC. I don’t know if it helps but mentally I have not really been concerned about my PC getting worse. I don’t really think about it, Even when waiting for the results of my monthly PSA tests. Does mental attitude make a difference??? Nahhhhh!!

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

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.

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!

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.

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