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Orchiectomy vs Holiday

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Posted 11/28/2018 3:01 AM (GMT 0)
I've been off this site for a long while. I have sent many here for the great help available.
Its been 11+ years since my DX, Update is this.
Robo in 6-07, Rad in 1-09, HDT ever since with Elligard(Lupron)every 3 mos .PSA was <.008
Took a holiday 4-2016 for 9 mos, checked PSA monthly , Remained undetectable <.008 for 6 mos, then rose slowly, .012, -.056- .072 - END Holiday. <019-<.008 <<<<<< to now <.008 for 18 mos.

What are the benefits of a Holiday and how high can the PSA get before its NOT manageable?
Upon reaching that level, End Holiday, did it go back down to 0?
Did you do another holiday?
I fear letting that genie out of the bottle and am considering the Orchiectomy. Going on Medicare in Feb.
No interest in sex. Wife either. I get Prolia for osteopenia.
HDT works!!
Are there other reasons to take a Holiday instead of the permanent HDT solution?
Orci guys, Did it work or still need follow up HDT? Adrenal sourced Testosterone?

Looking forward to your opinions, Thank you
Posted 11/28/2018 3:14 AM (GMT 0)
No direct experience, but for what it's worth I've considered that too.

If I ever go back on ADT it will likely be permanent, since for G9 types there are studies suggesting it's a better option. Some suggest too that there are fewer side effects of loss of testosterone from surgery, vs the medical approach. Lupron and its kin may cause more side effects than simply the loss of testosterone.

Some of the smart guys will be along shortly, I'm sure. But for what it's worth, to me a simple surgery vs expensive shots for the rest of one's life is a pretty easy choice.

Here's a thread on the Advanced Prostate Cancer website about this topic:
Lupron vs orchiectomy
Posted 11/28/2018 4:32 AM (GMT 0)
For the record, I am NOT one of the smart guys that Redwing mentioned. But...if I were to find myself in your situation, my personal preference would be for ADT vs the orchiectomy since one is permanent and one is not. Now if I got to the point where I knew my ADT was forever, I'd probably rethink this. But it's not clear to me that you're at that point yet. My two cents...this is clearly a very personal decision.
Posted 11/28/2018 3:22 PM (GMT 0)
I'm on my second holiday, so I am no expert. But here is what I have experienced so far.

First time:
I had been on Lupron for 30 months. AT that point I went on holiday for a year before it started back up. To confirm recurrence and to figure out doubling time we waited another 6 months before going back on Lupron/Eligard.

Second time:
This time, after having been on Eligard for 12 months, my last shot was about six months ago, no rise yet. But I expect it to rise by the next PSA test.

They say that PSA will start to rise in relation to how long you have been on ADT. But we are ALL different.

My understanding is that they wait for at least two consecutive increases in PSA before going back on ADT.
But for diagnostic reasons they may wait for a specific PSA level.
For me that level will be in the 1.0 to 2.0 range (currently at 0.08) so we can get some advanced imaging done(Axumin).

Post Edited (alephnull) : 11/28/2018 12:03:13 PM (GMT-7)

Posted 11/28/2018 9:31 PM (GMT 0)
My experience is limited. I was on HT from November 2012 thru May 2014 and have since been on a holiday for about 4.5 years. My psa has gradually increased from < .1 to .6 over a period of about 2 years. PET scan is still clean so we are hoping I might get another year or so of holiday. Not bad for a Gleason 9 Stage 4.

We are planning to end the holiday at or around 2. I have a great team at MD Anderson in Houston.
Posted 12/1/2018 9:05 PM (GMT 0)
Thanks for watching, Surely there are some multiple Holiday Cycle experiences out there.
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