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Salvage radiation therapy with 6 months Eligard
I'm starting salvage radiation therapy with 6 month Eligard injection,
My care provider is a bit vague about how long before starting radiotherapy I should have the ADT injection,when I asked him about the additional androgen blocker to stop lupron flare he says I don't need it with my low PSA of 0.32 . I have done some research on the optimum time to start ADT before radiotherapy and I found this article ( see link below) which suggests starting on the same day as radiotherapy without a flare blocker.
I would appreciate any thoughts on the subject.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029515/
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I started Lupron around the same time as I started SBRT no issues ,some
hot flashes but not bad my psa was at .4 at the time…..this was in early 2020.
Did you have the additional blocker to Stop the lupron flare?
Thanks
I started Orgovyx (an alternative to Lupron) a few days before my salvage radiation started. No issues, did not take anything to stop the "flare" (I call 'em power surges! LOL)
Conundrum: A friend began treatment at a center of excellence; 6 months ADT beginning 2 months prior to radiation.
My Rad Onc initiated hormone therapy at the same time as my simulation.
(whispering) they really do not know.
"I'm in the dark here" Al Pacino
And, I forgot to mention my friend is in a clinical trial that is being performed at a number of institutions; same protocol obviously.
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1 ReactionYes there seems to be different approaches as when to start adt with the radiotherapy, the starting of ADT at the same time as SRT as in the linked article I posted seems like a logical approach to me.
I have not seen a clear answer on when to begin ADT w/ salvage radiation.
The "flare" enhancement is the theory of the authors of the article that you posted.
My layperson research indictes that adding ADT to salvage radiation is believed to have a distinct benefit compared to radiation alone.
Optimal tine to start seems less clear. From 2 mos before radiation up to the time of beginning radiation seems to be the trend.
Note: A touted benefit of Orgovyx is the avoidance of Testosterone flare. And maybe that is because faster lowering at initiation and quicker recovery of testosterone at conclusion is also is promoted as a positive. And that is why a flare blocker is not rx'd with Relugolix (Orgovyx).
In any event, you seem to be on a good course in this complicated treatment of prostate cancer world.
Thanks for your response,
I am having the eligard injection 27th July and then starting the Radio therapy 2 days later. Unfortunately here in Spain they don't offer me the newer adt treatments such as relugolix.
When I asked about the flare blocker I was told it was not necessary with my low PSA.
Hoping for the best and wishing you all the best on your P.C journey.