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Stopping Lupron after 18 months

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Posted 2/29/2020 12:18 PM (GMT 0)
PSA still at 0 as expected after radiation and Lupron for 18 months. Urologist wants me to go on for another 6 months. Radiologist says enough is enough. I feel terrific, work out and walk, healthy diet, losing weight slowly on purpose, and no alcohol on a 90 day quit, maybe longer. New serious girlfriend helps too! I guess we will see what happens next......
Posted 2/29/2020 1:09 PM (GMT 0)
Coin toss with a G9 between 18 and 24 months. With your very high risk dx, some would say the choice is between 24-36 months. Better safe than sorry or enough is enough is your choice. Your docs don’t have your cancer and neither of them knows definitively what will be best. In several months as your T raises above castrate level, PSA trend will be telling. You are either be in remission or on an ADT vacation.

Glad you are feeling good, you will feel even better as the last of the ADT metabolizes out of your system and T recovers. As you note the Lupron will still be effective for many months before your at will recover. I was on ADT for 36 months and it took about 18 months before T was above 100. Another man I know only took about 6 months. YMMV.
Posted 2/29/2020 1:21 PM (GMT 0)
Personally, I might be inclined to do the extra 6 months, but ADT hasn't been a big deal for me. It might not make any difference either way in your outcome.

Good luck ahead!
Posted 2/29/2020 3:51 PM (GMT 0)
As JNF said, nobody really knows, so just like most things PCa, its a personal choice, and only you can decide. As you know, even if you stopped treatment now, the effect of the Lupron will linger (maybe both a good thing and a bad thing) for months.
Posted 2/29/2020 7:39 PM (GMT 0)
I don't have an answer to this, although I did 18 months as a G9. That said, the fact you have a new girlfriend could certainly give you a reason for getting your T back sooner than later!
Posted 2/29/2020 9:33 PM (GMT 0)
In my opinion, a PSA of zero is not 'expected'...
unless I misunderstand the (radiation) scenario.
To get back to the topic at hand, I agree that the decision is not an easy one.
'Better safe than sorry' or 'get it over with'.

My RO originally prescribed 24 months of Lupron, but then changed his mind (to 18 months) based on a Canadian study presented at a national meeting. This study has been published by now.
Posted 3/1/2020 2:24 AM (GMT 0)

Hello CJS10 ---

First of all, I give thanks that your treatments have helped you significantly.

From there, I also really admire your new LIVING goals ...

In this new year, as the winter snows melt away, your healthy living goals will inspire me this spring.

I have been walking each evening, and plan to start walking twice a day on weekends.

Going forward ---stay in close contact with your doctor, stay vigilant and proactive, and keep your lab numbers up-to-date.

I want to thank you for sharing your good health news, and your new healthy living goals. We all learn from each other, and your post will inspire others.

With all my best, from across the miles,
Cyclone --- Iowa State University
Posted 3/1/2020 3:40 PM (GMT 0)
I'am a G9 and I just finished my 18 months on 2/28
Posted 3/2/2020 7:26 AM (GMT 0)
In my lay opinion, I think that you could stop ADT after 18 months if you have achieved and stayed in remission levels of PSA during one whole year. This is the strategy used by famous medical oncologists in ADT intermittent treatment to allow recovery from hypogonadism risks and symptoms, and at the same time, avoiding possible earlier refractory.
In fact, ADT is palliative (doesn't cure) and can lead to androgen receptors AR mutation for the lack of testosterone in circulation. It has been found that cells survival skills are activated when threaten (Nobel prize for medicine in 2019) by modifying its DNA. This fact is verified in cancerous cells.
You could discuss with your doctor in going in an intermittent approach using trigger thresholds (off/on) based on PSA levels. I know of Gs9 guys that did it succefuly, restarting ADT when the PSA increased to a threshold of 5.0 ng/ml.
Best wishes.
Posted 3/2/2020 12:37 PM (GMT 0)
Wow! Thanks for all the helpful replies!
Posted 3/2/2020 6:06 PM (GMT 0)
I did 18 months together with Zytiga after HDRBT and IMRT.
I was undetected during the entire 18 months of ADT. However, three weeks ago, which was about a year after ADT ended, my PSA went up to 0.13.
I was also a G9. I am going for another PSA next week and see if it continues to go up or will it stabilize.

MP
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