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hormone therapy or not

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Posted 4/9/2015 4:55 PM (GMT 0)
My radiation oncologist is leaving it up to me weather I want hormone theropy along with radiation theorpy . Looking for opinions.
Posted 4/9/2015 5:19 PM (GMT 0)
HT has never been shown to be of benefit for a GS 3+4. Based on what evidence would he allow that?

Even with higher grades, it has never been shown to be of benefit with SBRT or HDR brachy. Even with LDR brachy, I suspect the benefit is more from prostate shrinkage. You didn't mention what kind of radiation he proposes. All of the types of radiation I mentioned outperform IMRT or IMPT, but don't make as much money for ROs. But even with those types, there's no evidence of benefit with a GS 3+4.
Posted 4/9/2015 5:32 PM (GMT 0)
My numbers are about the same as yours. My doctors didn't even discuss HT with me. My RO and URO were confident that all I needed was the RT.

So far that's been true.
Andrew
Posted 4/9/2015 5:42 PM (GMT 0)
He just brought it up as an option. I'm going to have igrt. He said if I wanted to do every thing possible to fight this cancer it was there for me to do. Just didn't know if it is worth having all the side effects with my lower Gleason scores.
Posted 4/9/2015 6:06 PM (GMT 0)
feels like overselling treatments. As Tall Allen says, doubtful it would be worth it for you. IGRT will zap the PC well enough.

Andrew
Posted 4/9/2015 10:21 PM (GMT 0)
My oncologist urologist trained at MD Anderson said and Tall Allen mentioned earlier, HT doesn't show any additional benefit for G6 or G7 cancer. He said it is best to save that option if radiation fails.
Posted 4/10/2015 12:03 AM (GMT 0)
If he left it up to you, he doesn't think you need it. go figure!
Posted 4/10/2015 12:54 AM (GMT 0)
Thanks for all the opinions. I won't get it. He just left it up to me because I asked about it.
Posted 4/10/2015 1:04 AM (GMT 0)
Got it! thanks! I think this will be but a memory sooner than later,ceptin the continuing psa tests. the negative PNI on biopsy very good news. I also thin going for radiation is a wise choice with your metrics.
Posted 4/10/2015 1:11 AM (GMT 0)
"HT has never been shown to be of benefit for a GS 3+4. Based on what evidence would he allow that?"

how certain are you of the 3+4?

ed
Posted 4/10/2015 12:51 PM (GMT 0)
I am on day 10 of 35 for SRT at MD Anderson. Surgeon not with Anderson. Both surgeon and RO said absolutely not on HT.i am 3+4.
Ed's question are you sure you are G7? Is great.
Hope all goes well in your process.
I am getting wonderful care from the team at Anderson.
Posted 4/10/2015 1:09 PM (GMT 0)
I was told that HT does enhance IMRT (I am a G4+3 with BCR after surgery and SRT).

It seems there is so much stuff that is not really known definitively.

HT has many SE and should not be taken lightly.

I think you are making the right decision

Mel
Posted 4/10/2015 2:40 PM (GMT 0)
But this is a Gleason score based off the biopsy, isn't a modest amount of those upgraded after excision?
Posted 4/10/2015 2:53 PM (GMT 0)
DH has been told no HT with his SRT. Which surprised me since he is G9, and was originally told he would most likely be on HT for the rest of his life . Now the RO, UO, and MO say there is no proven benefit for his case. I was so relieved they said no HT that I didn't think to ask why the change in opinion. I'm guessing it was because they found no SVI or LNI in his pathology after surgery...but I don't know. this disease just keeps me guessing.

edited to add: he didn't go on HT before RP because he signed up for a clinical trial and got the "no HT before surgery" arm, otherwise they would have started him before surgery..

sophie
Posted 4/10/2015 3:44 PM (GMT 0)
Soxx,

Ed (f8) does bring up an interesting question. Second opinions on biopsies are a good idea. As things stand you are in a risk category where ADT doesn't add any benefit but it sounds like you are worried that biopsy results don't always turn out to be right. Maybe a second opinion could help you deal with the uncertainty.
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