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Gleason 9 SO wants me to stop ADT @6 Mos for look see

Posted by chippydoo @chippydoo, Apr 18, 2025

My SO wants to stop ADT after 6 months and wait 2 months then test to see if PSA rises? Does this make sense? Just finished 3 mos of Lupron and switching to Orgovyx for a total 6-month ADT and had my 3 month visit with SO Thursday.
T is 3, PSA is below 0.014 considered UD.
Gl-9 Gr-5 Crib-3,4,5 RP 2.5 years ago, BCR 2.22 at 2 years followed with Neg PSMA Pet 4 mos. ago and 25 EBRT salvage due to
Suspected (no scan light ups) Prostate bed "Klingons". No known spread to lymph system.
I am a retired tradesman not a scientist.
I will be getting a second opinion next week from a local NCI Comprehensive Cancer Center.
Does anyone have experience with this category and treatment? Does it make sense based on your personal experience and treatment regimen?
Thanks for your thought's fellow warriors.

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Profile picture for Jeff Marchi
Jeff Marchi | @jeffmarc | Jun 11, 2025
In reply to @vircet "I'm just 2-1/2 months into Orgovyx, starting 2 weeks before my SBRT. My RO indicated that..." + (show)
Profile picture for vircet @vircet

I'm just 2-1/2 months into Orgovyx, starting 2 weeks before my SBRT. My RO indicated that maybe I can stop Orgovyx after 8 months or a year.
I was unfavorable intermediate at time of diagnosis, PSA 10.6, Gleason 7 (3+4) on 3 of 14 cores.
My first PSA test post-SBRT is July 8, seeing my RO on July 15. I plan on stopping ADT after 6 months, instead of 8 months or more.
Will you consider my plan as like "rolling the dice" too soon? So far, I have almost no side effects from Orgovyx.

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I don’t know if you noticed but somebody else posted today that their Gleason score after biopsy was 3+4 and they decided on a prostatectomy. Analysis of their prostate showed their Gleeson was 4+5 9. I’ve seen this many times and it happened to me, I was 3+4 after biopsy and 4+3 after prostatectomy. I can’t even count the number of times I’ve seen this happen.

You are having radiation and not a prostatectomy. It could be your Gleason score is much higher. Yes, you are rolling the dice, But for 3+4 if there’s nothing else involved six month is the NCCN recommendation. Why does your doctor say eight months to a year? Is there Something in your biopsy that makes him want to exceed the NCCN recommendation?

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vircet | @vircet | Jun 11, 2025
In reply to @jeffmarc "I don’t know if you noticed but somebody else posted today that their Gleason score after..." + (show)
Profile picture for Jeff Marchi @jeffmarc

I don’t know if you noticed but somebody else posted today that their Gleason score after biopsy was 3+4 and they decided on a prostatectomy. Analysis of their prostate showed their Gleeson was 4+5 9. I’ve seen this many times and it happened to me, I was 3+4 after biopsy and 4+3 after prostatectomy. I can’t even count the number of times I’ve seen this happen.

You are having radiation and not a prostatectomy. It could be your Gleason score is much higher. Yes, you are rolling the dice, But for 3+4 if there’s nothing else involved six month is the NCCN recommendation. Why does your doctor say eight months to a year? Is there Something in your biopsy that makes him want to exceed the NCCN recommendation?

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I will ask my RO when we look at my PSA in July. Thanks, Jeff!

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vircet | @vircet | Nov 10, 2025
In reply to @jeffmarc "I don’t know if you noticed but somebody else posted today that their Gleason score after..." + (show)
Profile picture for Jeff Marchi @jeffmarc

I don’t know if you noticed but somebody else posted today that their Gleason score after biopsy was 3+4 and they decided on a prostatectomy. Analysis of their prostate showed their Gleeson was 4+5 9. I’ve seen this many times and it happened to me, I was 3+4 after biopsy and 4+3 after prostatectomy. I can’t even count the number of times I’ve seen this happen.

You are having radiation and not a prostatectomy. It could be your Gleason score is much higher. Yes, you are rolling the dice, But for 3+4 if there’s nothing else involved six month is the NCCN recommendation. Why does your doctor say eight months to a year? Is there Something in your biopsy that makes him want to exceed the NCCN recommendation?

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@jeffmarc My clinical notes 6 months post-SBRT. My oncologist confirmed six months only, instead of 8 months to a year that was initially predicted in April.
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1 reply
Profile picture for Jeff Marchi
Jeff Marchi | @jeffmarc | Nov 10, 2025
In reply to @vircet "@jeffmarc My clinical notes 6 months post-SBRT. My oncologist confirmed six months only, instead of 8..." + (show)
Profile picture for vircet @vircet

@jeffmarc My clinical notes 6 months post-SBRT. My oncologist confirmed six months only, instead of 8 months to a year that was initially predicted in April.

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@vircet
Good to hear. That will allow you to get back to normal quicker.

Ask your doctor to put you on Orgovyx, Your testosterone can return sooner if you’re on that.

It works just the same as other a versions of ADT, And it doesn’t cause a testosterone flare when you first start on it.

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