ADT how long post Radical Prostatectomy & Radiation Therapy?

Posted by jbuuck @jonbuuck, Jun 7 7:30am

I’d like to know how long men have been on Lupron after a radical prostatectomy and adjuvant radiation. I’ve been told that I should be on Lupron for anywhere from 18 months to three years after my surgery, or two years if having radiation after surgery. My surgery was May 1, 2019, and I’m currently receiving 34 radiation treatments. I’d like to get off of Lupron as soon as possible after radiation, but I don’t want to cut it short if there is a benefit to a longer Lupron treatment.

I had radical prostatectomy January 2019, but recurrence of rising PSA Fall 2019. Started ADT November 2019, followed up with 34 radiation treatment Spring 2020. Continuing with ADT for total of 18 months per recommendations. I understand your apprehension on the ADT. The side effects are frustrating, hot flashes, muscle soreness, fatigue, and others…… That said I find that daily exercise (Even walks and light weights or body movement) is critical to minimize effects. Studies show benefit for combining ADT and radiation. Stay strong. Keep focus. Fight the battle. Beat the cancer. The ADT treatment period will come to and end and hopefully allow cancer free future.

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Hi @jonbuuck, I'd like to add my welcome to Jogger's. You may also be interested in these discussions about Androgen Deprivation Therapy (ADT)‎, including Lupron

– When do you start lupron shots? https://connect.mayoclinic.org/discussion/when-do-you-start-lupron-shots/
– Prostate Cancer: sex drive after surgery or other treatments

I'd like to bring in several members of the Prostate Cancer group who have had or are having treatment with Lupron, like @bradleym @john57 @safari1949 @alanr @403211th @sannira @philnob @semeon and @vernonkent to weigh in on your question about how long to take Lupron.

Jon, what side effects are you experiencing that have you considering stopping Lupron as soon as possible?

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The extent/term of lupron treatment often depends on the aggression of the cancer, especially if the cancer has spread outside the prostrate. Some MDs are more conservative in their approach and recommend long term lupron treatment to deprive the cancer cells of testosterone, which is the gasoline that feeds the cancer fire. Make no mistake, though. Lupron is a very powerful drug. Returning to sexual normalcy post-Lupron treatment irrespective of the duration is not a given. There are other drugs that can also suppress testosterone but also have their own side effects. One example is Xtansi. Consult with your MD on treatment duration and alternatives to Lupron. No easy choices but you're in control. Take it.

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@colleenyoung

Hi @jonbuuck, I'd like to add my welcome to Jogger's. You may also be interested in these discussions about Androgen Deprivation Therapy (ADT)‎, including Lupron

– When do you start lupron shots? https://connect.mayoclinic.org/discussion/when-do-you-start-lupron-shots/
– Prostate Cancer: sex drive after surgery or other treatments

I'd like to bring in several members of the Prostate Cancer group who have had or are having treatment with Lupron, like @bradleym @john57 @safari1949 @alanr @403211th @sannira @philnob @semeon and @vernonkent to weigh in on your question about how long to take Lupron.

Jon, what side effects are you experiencing that have you considering stopping Lupron as soon as possible?

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Hi @colleenyoung. Thank you for your welcome. I've been on Lupron since May 8, 2019. I'm experiencing the standard side effects: no libido, hot flashes, restless legs, loss of muscle tone, less energy, etc. My question is how long to remain on Lupron after I complete my adjuvant radiation treatments, which conclude in early July. I want to beat my cancer, but I don't want to be on the Lupron any longer than necessary, and the medical wisdom is all over the map on the length of time. I'm curious to hear what others who are farther down the road on this than I am have decided, and what their results have been. Thanks!

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Thanks for the posts! I am trying to decide how long to remain on Lupron after my radiation treatments conclude. If there's someone farther down the road than I am from radiation, I'd love to hear your thoughts on the matter.

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With my Gleason 9 I had prostatectomy September 2010, followed by 32 sessions of adjuvant radiation 3 months later. Side effect was some bladder leakage. Knocked PSA down to undetectable for several years. When PSA started to go up and reached 19 surgeon advised time for chemo followed by Lupron and Zytiga. Went down to .06 with that treatment. I have been on ADT for three years this month. PSA has been holding at .06 to .08. I asked PA how long I might be on this treatment? She just smiled and raised her eyebrows. I told her I took that to mean as long as it kept working and she nodded in the affirmative. Other than lack of Libido I really had no remarkable side effects. Well, maybe a little grumpy now and then and a few hot flashes the first 6 months or so.

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@mrbill

With my Gleason 9 I had prostatectomy September 2010, followed by 32 sessions of adjuvant radiation 3 months later. Side effect was some bladder leakage. Knocked PSA down to undetectable for several years. When PSA started to go up and reached 19 surgeon advised time for chemo followed by Lupron and Zytiga. Went down to .06 with that treatment. I have been on ADT for three years this month. PSA has been holding at .06 to .08. I asked PA how long I might be on this treatment? She just smiled and raised her eyebrows. I told her I took that to mean as long as it kept working and she nodded in the affirmative. Other than lack of Libido I really had no remarkable side effects. Well, maybe a little grumpy now and then and a few hot flashes the first 6 months or so.

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Thank you. I'm sorry your cancer returned, but glad to hear that the ADT is working for you.

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As Mr. Bruto said, nothing is carved in stone. There are many variables to take into consideration.

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@jonbuuck

Thanks for the posts! I am trying to decide how long to remain on Lupron after my radiation treatments conclude. If there's someone farther down the road than I am from radiation, I'd love to hear your thoughts on the matter.

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I have aggressive prostate cancer. I started this journey in December of 2014. I started with 1 Casodex shot then a month later a 6 month Lupron shot. The cancer had spread in to my bladder but receded by surgery time. In July of 2015 I had a prostatectomy. I have stage 4 cancer. In the summer of 2016 I had 35 radiation treatments. In sprIng of 2019 I had an additional 25 radiation treatments. I have been on Lupron for all this time except 6 months before 2nd series of radiation. I was told that I would probably be on Lupron for 2 years at a time then off for a while and then on again as Lupron seems to treat the cancer better this way. I am currently taking Zytiga and prednisone in addition to the Lupron shots. I also get a Prolia shot every 6 months as the Lupron seems to leach calcium from the bones. I have all the typical side effects from the Lupron but it beats the alternative. I am doctoring in Mayo at Rochester and feel very confident that my health care team are on top of things.

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I am so sorry, @zap57. I, too, am doctoring at Mayo Rochester. It seems with prostate cancer that there are no clear decisions forward regarding treatment. I, too, am confident on my treatment team, but it also helps to have the support of men who have traveled this road ahead of me. And please know that I am cheering you on!

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