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Last of the ADT (?)

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Prostate Cancer
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Posted 12/8/2015 7:47 PM (GMT 0)
We saw the Medonc last Friday for a check up. PSA still undetectable. Doc says no more Lupron. The last injection should wear off at the end of January. Then we wait and see. DH was so happy that he didn't even mind the Atlanta 5:00 traffic as we made our 2 hour (which turned into a 3 hour) drive home. Total sentence on Lupron of 12 months.

I'm just a little concerned that 12 months might not be enough, although DH says we have picked the best docs we could find, now we need to trust them to know their stuff. Thoughts?
Posted 12/8/2015 7:59 PM (GMT 0)
Well...as long as they will monitor his PSA closely, he should be ok. I thought 18 months was the typical minimum, but I also know that every situation is different, every treatment, every diagnosis.

I'm sure others with more insight on this will respond, but that's my amateur answer.
Posted 12/8/2015 10:54 PM (GMT 0)
Candidly, I would have expected another six months of ADT. That I am aware of, there isn't a lot of research that looks at one year of ADT vs other durations. There are studies that show that six months of ADT doesn't seem to be as good as 24 to 36 months (ie. 6 months isn't enough) and there are studies that tried to find an advantage to 36 months as compared to 18 months and failed to find a difference (as far as we know 18 months is enough). But is 12 months as good as 18? is it better than 6? I dunno. I lean toward the 18 month end just because it is hard to over-treat Gleason 9 disease and 18 months is more than 12 months.
Posted 12/9/2015 5:07 AM (GMT 0)
It can get confusing (at least, I get confused) looking at research studies about the use of ADT with radiation because it may (or may not) be different depending on whether it's primary radiation or salvage radiation. In your case, we're talking about ADT with salvage radiation (and presumable with enough salvage radiation). So the best we have is one study that proved that 6 months of ADT was better than none.

Combining ADT and salvage radiation therapy improves outcomes

But is a year better than 6 months? Is 18 months better? Is 24 months better? No one can answer that with assurance. We have to rely on the RO's judgment and patient assessment of how tolerable ADT is vs any loss of control from stopping too soon.

- Allen
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