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Hormones after Radiation or Not?

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Prostate Cancer
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Posted 2/6/2018 2:15 AM (GMT 0)
My brother finished his Radiation for Gleason 4 + 3; Possibly higher.

He had hormone therapy prior.

RO said Hormone therapy after is not necessary.

Uro had said he would be getting hormone therapy after.

My brother doesn't want. Plans to ask Uro why when he meets with him. What do you all think?

He was
4.56 at diagnosis in June
No scans, mri etc given : Insurance wouldn't cover.
Biopsy G 4 + 3
2 or 4 Positive out of 12 Cores

No further blood tests have been given to test spa at this time.

Thank you,

According to my brother, he says there are no studies out there that say hormone therapy after radiation is beneficial
Posted 2/6/2018 3:03 AM (GMT 0)
The normal course would be to stop the HT and wait to see what the PSA does. Giving HT before is just to weaken the cancer cells so the RT can be more effective.

It's possible that he doesn't need any other treatments. All you need to do is monitor the PSA levels (typically every six months).

Andrew
Posted 2/6/2018 3:08 AM (GMT 0)
What Andrew said. (Andrew, glad you are back full time, you just couldnt stay away, like most of us lol)

I would tell your brother to ask very specifically why not wait until psa settles down first, and what studies or data, the Dr is relying on to make this recommendation. Brother has to be his own advocate, Drs are incentivized to treat. Not saying they are all greedy and putting their own interest ahead of their patients, but it does happen.
Posted 2/6/2018 5:58 AM (GMT 0)
Please clarify - he had hormone therapy before and during... and is the question now whether he should consider extending the duration of the HT for a longer period? If that is the question, the evidence (DART 01/05) is that for an intermediate risk (GS 7) patient, 4 months total HT (2 months before+2 months concurrent) was equally effective as 28 months of ADT. Another study (Nabid et al.) showed that 6 months of HT was superior to no HT in intermediate risk patients. There is some question, however, about whether "unfavorable intermediate risk' patients (e.g., those with GS 4+3) might benefit from a longer course of HT, just as high risk patients do. So it is very much a judgment call.
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