Snowboat -
For the goal of vascular protection, all you need is 5 mg daily. But you can boost that up to 20 mg on play days. Not much to that can be done about
the libido while you're on Lupron.
There is no evidence that Lupron is of any benefit in favorable intermediate risk patients like yourself. If that was your last shot, you may want to discuss not renewing it. The evidence isn't definitive yet, but is worth discussing.
Allen said...
Favorable vs. Unfavorable Intermediate Risk
In an earlier article, we noted that Dr. Anthony D’Amico raised a caution that the results may look very different if the intermediate-risk men were divided into favorable and unfavorable groups. It may be that with further follow-up time, significant differences will appear among the intermediate-risk men, and particularly among those with unfavorable features. In a retrospective study by Castle et al., in which intermediate-risk men were divided into favorable or unfavorable intermediate risk, favorable intermediate-risk patients had no discernable benefit from the addition of ADT. Unfavorable intermediate-risk patients had significantly higher 5-year freedom from failure if they also received ADT (74 vs. 94 percent, respectively). Similarly, Edelman et al. found that ADT combined beneficially with RT only in intermediate-risk patients with Gleason scores of 4 + 3, more than 50 percent positive cores, or multiple intermediate-risk factors.
Another retrospective study by Keane et al. confirming that finding was presented at the recent Genitourinary Cancers Symposium. They analyzed the oncological outcomes of 2,668 intermediate-risk men (71 percent favorable, 29 percent unfavorable) treated between 1997 and 2013 with dose-escalated RT and with and without adjuvant ADT (median 4 months). After a median follow-up of 7.8 years, they found that there was a significant amelioration of the risk of prostate cancer-specific mortality among the unfavorable risk patients who also received ADT, but adding ADT did not make a difference to prostate cancer-specific mortality in those men categorized as favorable intermediate risk.
/prostatecancerinfolink.net/2015/03/12/androgen-deprivation-therapy-and-escalated-dosing-in-radiation-therapy/