Lupron Treatment Duration: How long were you on it?

Thank you for taking the time to answer my post in detail. I have read it more than once and consider it my introduction into this new phase of our lives. The last sentence "“Note “ was very encouraging.

There's a long time adage about PCa: "If you can cut it out [prostate/PCa] and put it in a jar, you've cured it". That 's long been my mantra and my anticipated choice while working in the prostate Ca field. And that seems obvious if you are highly certain your PCa is confined to the prostate. Yet, when my surprise turn came at 79 yrs, with 30 years of monitoring PSA, a rising PSA over 4 yrs to 7 ng, led to a Gleason of 4+5, but a clear PSMA PET scan forced me to review this long held idea of the choice I would make. My final decision was based on three things; Fewer side effects with radiation (although ADT is not benign due to side effects), greater confidence in ruling out metastases (PSMA PET), and significant improvements in targeting the radiation (5 days at higher dosage) and minimizing the likelihood of side effects (e.g. Hydrogel placement, etc). So, a comparison of side effects flipped my prior assumptions of my treatment choice. Note: Advances have be sufficiently rapid that I found it difficult to make decisions based on published data in the literature because my judgement was they often do not reflect these current improvements.

Good luck to you both.

My husband was recently diagnosed with prostrate cancer . I am trying to learn as much as I can joined this group and your post jumped at me. It described our similar situation and the dilemma we are going through His PCP immediately said surgery but my husband is going back and forth between surgery vs radiation. PSA was 12 and the Gleason 3+4. Positive effects of a course of action is good to know but I want to know the negatives of either procedure. - surgery /radiation. Your post brought reality to the picture considering his age (76) and quality of life. I need to be prepared for whatever route he chooses. Thank you again

After consulting several urologists, I concluded that based on my age (73), Gleeson scores, confinement of my cancer within the prostate capsule, and the relative post-treatment side-effects of both options, that radiation was the best choice for me. I went back and forth on deciding between oth options. The tipping point was a conversation with a Mayo urologist and surgeon who put it this way (I'm paraphrasing.), "My father is your age. Either surgery or radiation is a good choice to attack the cancer. However, the possible complications from surgery -- ED, incontinence, etc. -- are more consequential in the near term and can contribute negatively to your lifestyle. Radiation consequences are apt to more consequential in the longer term. At 73 or older, there's a good statistical likelihood that another disease or medical malady is going to enter your life in the not too far distant future. Do you want to suffer with surgical post-effects from prostate removal only to be hit from the side by another medical dilemma? Why suffer more than you need to." Put simply, for me it was a trade off between "pay now or pay later." I chose the former. Your calculus may be different, keeping in mind that the long term survivability rates for both treatments are effectively the same.

I did 18 months, the attached chart shows my clinical history. The side affects were mild fatigue, hot flashes, muscle and joint stiffness and genitalia shrinkage. I did not lose my libido. Throughout those 18 months I maintained my "normal" life, exercised, travelled, worked in the garden, walked my dog....I did keep an eye on my weight which rose about 10 pounds despite watching my diet.

There are various studies you can look for, some will say six months when you are ding it in conjunction with SRT, others will say 18 months is just as effective as 24-36. There is intermittent ADT and of course, "lifetime" ADT or at least until you become castrate resistant...

If you decide to stop AFT, consider basing it on response to treatment, as an example, in my case, PSA had dropped to undetectable and stayed there for the 18 months, then, if you do sop, have a plan to actively monitor your PCa and decision criteria about if and when to go back on treatment based on imaging, labs such as PSA which could provide doubling and velocity ties, any other clinical data such as cardiovascular health. I see my urologist every 2-4 months for labs and a quick consult.

You will find a wide variety of decision "triggers" for resuming treatment. Some will say when PSA hits 4, I've seen 10. As always the questions is, if advanced PCa is not curable, what do I gain if I start treatment back up "early? Does it increase my overall survival...again, you'll find studies all over the map. For me, I would want hard clinical data, imaging when PSA hits .5 to 1.0, labs spaced 2-3 months apart showing PSADT and PSAV, then treatment for a specified period, if the results are "favorable," go back off treatment and actively monitor, repeat.

One has to balance quality of life versus quantity, how one reacts to treatment (some experience horrendous SEs from ADT to include depression), the financial toxicity, life expectancy...It may be that we are entering a phase where we can "live" with PCa, like people who have AIDS and Diabetes then die from something else...That decision is yours as to treatment, what, when, for how long.

I chose to be aggressive in the face of aggressive clinical history and data, it has worked, almost four years of no treatment. I am not saying that I'm cured but the time off treatment has been great!

There is no one "right" decision. We must each make our own based on our specific clinical history and personal preferences.