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Posted 10/16/2019 10:00 PM (GMT 0)
garyi, the HT was my choice. My RO actually told me that HT showed no benefit for anyone with PSA under .34 (he cited a study). He gave me the choice.
Me, being who I am, opted for HT, as I figure this is my last shot, so let's shoot for the moon. HT SE minimal so far. I'm more concerned about lasting RT SE's.
Posted 10/16/2019 10:19 PM (GMT 0)

garyi said...
39 sessions, 70.2 Gy, SRT (7020 rad, 1.8 Gy per fraction) Radiation was a non issue, but the after effects of ADT (six months of Lupron and seven months of Casodex) were/are uncomfortable. After reading hundred of medical studies, I don't believe most patients derive ANY benefit from ADT.

Progression-free survival by taking hormones during RT is a myth that some RO's promulgate, hoping for improved results, but not paying for, suffering, or treating the consequences. It 'may' be beneficial for some high risk patients, with high PSA, but it isn't an 'across the board' benefit for most of us, IMO.

Caveat Emptor, brothers!!!

wow. you are smarter than the doctors!
Posted 10/16/2019 11:55 PM (GMT 0)

wow. you are smarter than the doctors!

You're funny.
Posted 10/16/2019 11:58 PM (GMT 0)

JayMot said...
garyi, the HT was my choice. My RO actually told me that HT showed no benefit for anyone with PSA under .34 (he cited a study). He gave me the choice.
Me, being who I am, opted for HT, as I figure this is my last shot, so let's shoot for the moon. HT SE minimal so far. I'm more concerned about lasting RT SE's.

With all I posted, Jay, I did the same thing you did.
Posted 10/17/2019 4:52 AM (GMT 0)
SRT of a Gleason 6... No ADT... 32 sessions of 2 for 64 gys total.

pasayten
Posted 10/17/2019 1:40 PM (GMT 0)

garyi said...
I don't believe most patients derive ANY benefit from ADT. Progression-free survival by taking hormones during RT is a myth that some RO's promulgate... It 'may' be beneficial for some high risk patients, with high PSA, but it isn't an 'across the board' benefit for most of us, IMO.

Gary (and others interested) the following snippet from Combining Androgen Deprivation Therapy (ADT) and Salvage Radiation Therapy (SRT) improves outcomes supports your opinion that ADT is not necessarily appropriate for every patient:

(Update 3/21/2019) Fossati et al. identified 3 risk factors that determined optimal duration of adjuvant ADT with salvage RT:

Stage ≥ pT3b
Gleason score ≥ 8
PSA≥ 0.5 ng/ml

Men with 2 or 3 risk factors benefited from up to 3 years of adjuvant ADT; men with 1 of the 3 benefited from up to 12 months of ADT; men with no risk factors did not benefit from adjuvant ADT.

Other recent studies suggest that 18 months ADT is often as effective as three years.
Posted 10/17/2019 4:09 PM (GMT 0)
Thanks, Rob. Several years ago I posted links to a number of clinical studies questioning any proven ADT results, that mirror and expand on the issue. IMO, it's a tougher decision than the choice of radiation or surgery.
Posted 10/17/2019 4:21 PM (GMT 0)
Gary,
I suspect you may be at least partially correct about that. A recent ASCO paper I posted did an in-depth review of managing recurrent PCa. Their conclusion was that adding ADT to SRT when the PSA was below 0.5 was not beneficial.
Posted 10/17/2019 5:22 PM (GMT 0)
I had 66 Gy in 37 treatments back in 2017, in addition to 6 months of ADT (Casodex & Avodart). So far so good.
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