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ADT therapy

My Information is:
Gleason 4+3
PSA 8.3
Clear bone scan and MRI
Decipher reports high intermediate risk
F-18 PSMA PET scan scheduled in 1 week
Most likely will do Proton Therapy and have visited 2 centers, met with 3 radiologists and urology oncologist
Have read the Walsh and Scholz books, 2 proton therapy books, read numerous articles and watched a lot of you tube videos. Quality of life is most important with length a close second.
One radiologist says 2 month pre radiation adt therapy and 4 months during and after. Another says ADT would be only marginally beneficial considering age and short term and long term metabolic issues with ADT. ( My Dad died from Alzheimer's at age 76 and his sister and brother had it also) He also said an approach might be to complete radiation treatments and try oral adt or shorter term injection to see how tolerated. Term could be 4 months or less to limit metabolic damage. Some studies have determined pre treatment ADT not beneficial and not necessary to shrink prostate to radiate it. Has anyone used an approach similar to this with either photon or proton radiation?

  1. You certainly have done a lot of research and I so agree on quality of life issues. I scored a Gleason 9 and decided on surgery in 2013 as a reoccurrence was possible. All looked good for a while. In 2018 I needed radiation and also opted for ADT. We are now in 2022 and I am still in remission.

    1. Today I would consider proton which was not available to me at the time. We are all different as far as treatment impacts and outcomes are concerned. I had a very rough time with ADT and yet know men who had almost no reaction to it. You just do not know in advance. Best path for me was just to make a decision and not look back after. Do keep us up to date

      1. As I head towards ADT as a precursor to radiation therapy, following a detection of disease progression during Active Surveillance, I can’t help but wonder why FDA can’t approve interventions with less toxicity such as using 2nd/3rd generation AR inhibitors as monotherapy, at least for a three month trial period to see if signs of disease progression can be halted, even reversed. Trials like these hold hope for hundreds of thousands of patients but the long time it takes to have FDA approval following trials is a source of frustration 👉🏼 https://clinicaltrials.gov/ct2/show/record/NCT02972060?term=Darolutamide&cond=Prostate+Cancer&draw=2&rank=3&view=record

    2. Agree there are numerous opportunities for progress. Yet we have to face the fact that a very large bureaucracy is firmly welded in place with its own unique set of protocols. FDA sort of reminds me of the movie title "Mission Impossible" 😀
      Dennis(ProstateCaner.net TEAM)

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