Is adt always necessary

If you want "The Best Chance" of no re- occurrence, then you do ADT for at least 6 months. It sounds like your RO feels the side-effect load that comes with ADT is not worth the benefit it might bestow....He might be right....

for best results do ADT. the fact is without removing the prostate there's no way of knowing the grade and extent of your cancer. to me, the doctor is going with best case and he's not the one with cancer. you are.

now take a look at the signatures of the guys who had surgery and you'll see many of them were upgraded after the prostate was examined.

I was G7 3+4. all 12 cores positive and a couple bigly. we assumed worst case and went with kitchen sink. yeah treatment sucked but I am now entering my 9th year of remission.

you get one chance for cure. Hit it with everything you have, including ADT.

There is no black and white answer, only opinions. Like everything else with this $%^&* disease

F8 nailed it. You really don't know what's lurking in the basement. Short term ADT very doable, it is an interesting experience, short term that is

Like a eunuch in the Quinq dynasty

he may have told you what you wanted to hear but I don't agree with blanket statements like that, and I believe it's possible that you misinterpreted what he said. I had my uro and a team of radiation oncologists who believed ADT was right for me. the only thing they differed on was duration.

Gee, ADT really gets a bad press doesn’t it. To the point where men are willing to risk their lives just to avoid the side effects.

I know I am a lonely voice in this Sh!tPit of PCa, but not everyone has a terrible time with ADT. I am one of the lucky ones. I initially had ADT for 12 months which held my PSA at zero for almost 2 years. Side effects for me were minimal. I certainly had hot flushes, but they only lasted for a few minutes, I did put on a bit of weight, but not disastrously, only a couple of kilos over 2 years. But no bad fatigue and no mood change or depression. I continued the moderate exercise which has always been a part of my life and I continued to play golf a couple of times a week. Certainly it was good to have a vacation for a couple of years, but when PSA came back up, I wasn’t too bothered about going back on to ADT.

This time I was prepared for the weight gain and modified my diet, mainly in respect of portion size. I have a sweet tooth, but reduced my sugar intake, though I still enjoy an occasional bit of chocolate and certainly still enjoy a glass of red. Have not gained any weight this time round.

I have been back on ADT for 15 months now, and as before, feel fine. Still exercising and still playing golf. I do note that I have lost a bit of strength, but not sure how much of that is due to ADT or just getting older now. At 73 I guess I can’t expect to be hitting 250 yard drives like 8 used to!

Now the purpose of this is not to gloat over the poor guys who really suffer, and there is no doubt that is the majority, but just to say don’t fear what you haven’t experienced. It may not be that bad and it just may save, or extend, your life.

As a postscript I would point out that I am on Zoladex which seems to be the most common brand used here in Australia. I note that the majority of the US guys on this forum are on Lupron. Purely anecdotally most of the guys I know locally on Zoladex have minimal issues, whereas it seems most of the Lupron guys do have problems. Just saying.....

Chas

This is controversial. You may not need any ADT with your favorable intermediate risk cancer, but no one can say for sure. Here are the studies fueling the controversy:

/pcnrv.blogspot.com/2016/08/androgen-deprivation-therapy-adt-and.html

Cribriform lowers the risk of your diagnosis - it does NOT raise it.

Cribriform raises the risk when it is found in a core that is otherwise GS 3+3. But since 2014, pathologists have reported ALL cribriform as Gleason pattern 4. Thus what used to be GS 3+3 is reported as GS 3+4. So anything reported as GS 3+3 is lower risk than it used to be because it no longer contains the higher risk cribriform pattern. And anything reported as GS 3+4 is LOWER risk than it used to be if it contains cribriform pattern.

Your Decipher test did not look at patterns - it looked at genomics.

Hey tall allen lost your post about the cribiform ..can you repost

Thanks, i needed a good laugh

Stan1961 said...
Also my dr said we should not watch this ..cribifirm means it has legs and can grow faster than the average tumor ...so I don’t know how that can’t be high risk

What shouldn't you watch?

Stan-
Most guys are diagnosed with GS 3+3. So if that has cribriform pattern, it is higher risk than ordinary GS 3+3, which is why it is now designated as GS 3+4. But because it is lower risk than conventional pattern 4, your cribriform variant makes the risk of your diagnosis LOWER not higher. This has implications for men considering staying on AS. It does not make you "high risk."