The RT / HT Combo Treatment...

One of the main concerns I have with using HT as an adjunct to radiation treatment is that at some point in this battle, I'm likely to NEED hormone therapy and I'd like it to work for as long as possible....Yes, it seems combining radiation with a short treatment of HT makes the radiation more effective, a better result from the RT is achieved. It also makes Radiation Oncologists look better as their patients PSA level drops to undetectable....

But HT seldom works for very long, for many men, two or three years and the cancer no longer responds to it, it becomes useless as a tool for fighting this disease....So I'm willing to give the R-doc a year on HT to enhance the effect of his radiation, but no more..I'm going to save what's left of my HT window of effectiveness for the end game, for when I really want another year or two of "good time"......

Have the rest of the forum members who are in this boat given this any thought?

Fairwind,
The common perception is that HT only lasts 3 or 4 years. This is a false premise. It depends on the stage at which the HT is started and the biology of the particular cancer. If you start it when some doctors recommend, such as the beginning of bone mets, then you are correct and 3 -4 years is common. If started early and done intermittenly then 10 years plus is much more common. It aslo depends on the cancer's biology; some cancer types respond very well to HT; if your psa goes to .05 and stays there for 6 months then you can expect HT to work for quite a long time. If you review some of the work that Dr Bronhoff has done in identifying different types of PC then tailering treatments to individual biology HT can be very effective. All HT is not the same; some patients begin when their psa is high or have symptoms and get a shot of Lupron with very little monitoring. Other patients see a specialist oncologist who performs futher testing, uses HT meds in combinations and different doses and monitors at least monthly through a panel of markers. These patient tend to do much better.
JT

The original studies that demonstrated that HT could bolster the effectiveness of RT, especially in high risk cases, used first three years then two years as the time frame for putting patients on HT...Since that's what the trials demonstrated, that's the time-frame R-docs recommend today...But more recent trials done outside the United States seem to show that shorter treatment periods, one year or even 6 months, work almost as well as the longer treatment periods....

NOBODY talks about what effect using HT now, as an adjunct to primary treatment with curative intent will have later should the RT fail and the patient, two or three later goes back on HT as a palliative treatment for his now advancing cancer...Does the earlier use of HT limit its effectiveness later on??

Using HT as a adjunct to radiation treatment is a relatively new development in the treatment of prostate cancer. It is by no means universally accepted. So I guess I'm asking questions here that have not been answered yet....But they need to be..Subjecting men to hormone treatment should not be taken lightly. The side-effects are progressive and unpleasant and in some cases deadly. Determining the optimum time period for these treatments should not be that difficult or expensive...

John, Ed, Tony, thanks for taking the time to respond..Your insights have been helpful to me...