Is this a valid plan for a G9?

Hurray, my husband is down to 17 sessions of RT remaining and is doing pretty well. His age is 59.

We are now seriously weighing what our next course of action will be. Here is what we would like to do and would appreciate your input:

* In Feb 2016, his first Lupron shot (4 mo) will expire.
* Then he will get a 6 month Lupron shot
* Once that expires in August, he would like to go off Lupron and see what happens with T and PSA
* If PSA doubles quickly or has 3 consecutive rises, then he will go back on HT probably for good

Quality of life is so important to him. And since he is feeling pretty bad on the Lupron now, he would like to try this. Hopefully my new signature will show up below.

We would appreciate any thoughts! Thank you!!!

Hi Peanut...just curious what is his current PSA? I see initially it was 11.4, and was 8.4 after a round of chemo.

Just out of curiosity, how is he feeling bad? I'm just thinking it might be more attributed to the chemo and cancer itself, and not just the hormone, as he's only been on that 6 weeks or so.

I would think as a higher risk, 18-24 months would be a minimum for HT. As RedWing said, in this case it would be much better to err on the side of too long instead of not long enough.

Don't plan your life around when to start and stop the HT....just fight the fight, work with your oncologist, and live life. Don't let SE's hold him back, get out and do everything he did before!

It's not an easy journey, but it's also one your aren't walking alone!

Best of luck!

Thanks all. JPenn -- we don't know what is current PSA is. I didn't think they tested while one is under going radiation. And when I say he is feeling bad on Lupron it's due to a number of factors. Now it's starting to get to the point where the Cialis is no longer working. He's getting depressed. Has hot flashes and says he just doesn't feel right.

Also updated my signature to say his bone scan was clean at diagnosis.

I would give it 2 years....You only get one chance at this....But NONE of us here are doctors and there IS some controversy about how long is long enough...For prostate cancer, the "standard of treatment" is changing almost every day...

I do hope Tall Allen finishes the final 1,600 words of his novel today and weighs in, but I believe the studies that indicate the similar survival rates to continuous versus intermittent HT are only when someone is trying to control the cancer after confirmed spread--not during initial treatment like your husbands. Don't take that to the bank, but that's my understanding.

Like Michael_T I don't think the studies that compared intermittent and continuous HT were looking at the use of HT as an adjunct to radiation to make it more effective. They were looking at the use of HT in men with advanced cases where they were attempting to delay the disease, not trying to cure it.

I certainly sympathize with his dislike for the effects of the hormones. I did two years of chemical castration and hated every minute of it -- and, as an added bonus, the hormones take a year to wear off so you get a third year free, like some sort of demented TV offer for impotence if you act now.

But...

I did the two years because they greatly improved my odds of getting out from under. Was it kinda depressing? Yes. At one point I was on two antidepressants -- both Prozac and Wellbutrin -- but I got through it. He might want to avoid the SSRI drugs (Prozac and similar drugs) since they have annoying sexual side effects. The hormones make sexual activities difficult but when you add in a Selective Serotonin Re-uptake Inhibitor it shuts a man down completely.

It is all up to him, of course, but if I were in his place (and I have been) I'd stick with the androgen blockade if his oncologist recommends it and talk to his doctor about ways to mitigate the side effects if they cause him excessive problems.

So if he stays on HT for 24 to 36 months, what are the odds that his libido or T will ever resurface AT ALL?

This is so scary for us.

Peanut,
I was on HT for 36 months. You can see my whole treatment plan in my signature. My testosterone and libido bounced back quickly ~ 4 months after my last Lupron shot expired. I think it came back much faster than typical. However, I wanted to post this to give you some positive perspective.

I had an internal debate with myself over every Lupron shot. I tried to talk my doctors into stopping early. None would agree. Eventually I just hunkered down and doggedly pushed through the entire 3 years. I managed side effects with exercise. Also, my wife and I purposefully maintained an active sex life through the entire HT treatment period.

Southern Comfort

Southern Comfort -- Do you mind if I ask how you "purposefully maintained an active sex life through the entire HT period."????

Did Vitamin V continue to work for you or did you use Trimex or other approaches?

Peanut,

Here's a link to an abstract of a study at the University of Toronto where they looked at testosterone recovery following two years (more or less) of hormone therapy:

Testosterone recovery after prolonged androgen suppression in patients with prostate cancer.

With a three year followup they found that 93.2 percent of the patients recovered to a non-castrate level of testosterone after a median of 12.7 months and 71.5 percent recovered to "normal" and/or "baseline" levels, but that took almost two years.

They found that younger men recovered more reliably and that men receiving a shorter course of treatment also recovered somewhat faster.

Or to translate that into simple terms, better than nine out of ten guys saw some recovery and seven out of ten got back to more-or-less normal levels of testosterone. Guys younger than 60 did a lot better than the older ones and, since your husband is only 55, he should be in a position to beat those averages.

Peanut,
You've got some great advice here from some pretty heavy hitters for this forum. I can count 5 or 6 guys that have commented that I'd call my inspirational leaders.
I did a 2 year sentence and it sucked. But I went into it knowing 2 or 3 would be the option. Sometimes it's just a mind set. I think 2 years is doable. Exercise helped a lot. Talk with Drs about side effect, they might be able to help. For me testosterone bounced back quickly.

Thank you all again for such wonderful input! The RO just prescribed a anti-depressant for him today (venaflaxine) which he says will also help with the hot flashes. Once he starts feeling better (less depressed), I will start talking to him about the 18 month plan. It will take some convincing.

Allen, I will pull the Green Tea. I think that is the only antioxidant. I had just started him on that last week. But he also drinks alot of green tea. I wonder if that's ok. I wish I could say he is getting vigorous exercise. I'd say he walks 20 minutes a day and that's about all he's up for right now.