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Hormone Therapy (ADT) when ArteraAI Test says it's not necessary
My background: 67 years old; physically fit; not over weight; no diabetes; diagnosed in January 2026 with a Gleason of 7 (4+3); no metastasis shown (PET scan); PSA ~8.
[Please bear with this preamble. It's relavent.] I was originally seen by a surgical oncologist at Johns Hopkins in Baltimore. He recommended radical prostatectomy. I was on board with it, but read more about good outcomes with fewer side effects of proton therapy, so I got a referral to a radiology oncologist (RO) at JH. She said I'd be a good candidate for proton therapy, and offered me treatment at JH's proton therapy location in D.C. (an hour away) or at UofMD Medical Center in Baltimore (20 minutes away). For the recommended 5-1/2 weeks of daily (M-F) treatments, the latter was the obvious choice. Have met with UMMC ROs.
Part of UMMC's treatment plan is 4-6 months of hormone therapy (ADT), either Lupron shots or Orgovyx pills. However, the JH RO had submitted my biopsy and test results for ArteraAI analysis. The results came back and her recommendation was "low risk of metastases and not likely to benefit from hormone therapy. Therefore we would not recommend ADT with radiation."
The JH RO followed up by saying that UofMD was being conservative and that she didn't diagree with doing ADT, but stood by the ArteraAI results and still didn't think ADT was necessary. Of course, I want this cancer gone, but I don't want to deal with ADT side effects (in addition to the many others I will endure) if not really necessary.
So, has anyone in a similar situation opted out of ADT and had good outcomes or wished they had gone ahead with ADT? Are ADT side effects bearable? Any firsthand opinions on the ArteraAI testing? Thank you.
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@heavyphil
I was castrate resistant to ADT. That doesn’t make me resistant to the other drugs. It’s interesting that Zytiga helped, Though my PSA was only undetectable one month out of 2 1/2 years. Since its big deal is it reduces testosterone even more, it’s no wonder it didn’t work 100%. When I was on Casodex for the first 15 months, my PSA just kept rising, slowly.
Darolutamide works completely different so it’s not surprising that it did work. When I become resistant to it, I will be completely castrate resistant.
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4 ReactionsI had to look this up (I'm still learning) and read up on castration-resistant prostate cancer (CRPC). I'm sorry that you are going through this and hope that the Darolutamide continues to work for you. 🙏
@thmssllvn The AteraAI may recommend many things, but the context for me was whether ADT was necessary given all of my metrics. That's really all I know. As I'm learning, no answers on any of this are definite, so I maybe got my hopes up about skipping ADT. But if it gives me even an iota of benefit, it sounds like it's worth it.
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1 Reaction@clevelandguy Yes, when I met with the team at UMMC, their descriptions of the ADT drugs made it clear to me that Orgovyx was the way to go. Then the AterelaAI indicated that ADT wasn't necessary, per the Johns Hopkins RO. But I will do it anyway just to increase my odds of a good outcome.
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1 Reaction@brianjarvis Thanks for that. UMMC has offered a strength training study in concurrence with the proton therapy. I think it would be 2-3 times per week along with the proton therapy 5 days a week for 5½ weeks. If they recommend I do more than the study offers, I will.
@clevelandguy
Great post but so many doctors will not do what you say because they are stuck with old technology by the health insurance companies, big pharma, and fear of being sued if they do any new types of care.
@pesquallie
Hi,
From what other people are saying on a couple of forums I participate in it’s pretty much a standard protocol. Have not heard any complaints that they had to go around doctors or health care networks.
Dave 3+4