ADT and SRT Journey Part 2

Thanks Jim for starting a new thread!

Mike

Spoke with my RO, Dr. Ko, this morning (Monday in Saipan & Guam) about the weird <0.05 PSA I pulled a week ago. His reaction was the same as TA's: it's either a medical miracle or a lab error -- he suggests the error may be in diluting/pipetting the sample. He's ok to wait to start treatment until after a retest if I want, but he's confident we'll soon see the value return to something like 0.1. I think I'll ask my PCP to write a script for a retest tomorrow, with every expectation that the <0.05 will turn out to be an outlier. After the blood draw, I'll start on Casodex, followed by Lupron injection and simulation 2 weeks later. Aiming to start my fractions in about 3 weeks.
I mentioned to Dr. Ko that Drs. Biagioli and Abramowitz proposed just 6 months on Lupron, compared to his recommendation of 9-12 months. He stuck to his guns but conceded, rather diplomatically, that the ultimate decision will be up to me. He thinks given my pathology at least 9 months would be prudent. Didn't mention any studies, and I didn't ask. TA, if you're reading this: any studies supporting longer course of Lupron for G8 pT3a N0 with salvage?
--SP

I had asked my RO if he thinks it would be prudent for me to go longer than 6 months with ADT. He recommended that I don't, stating that ADT has its own longer-term negative side effects (cardiovascular and bone weakening among others). And this is with a higher Persistent PSA.

AZ Guy said...
I had asked my RO if he thinks it would be prudent for me to go longer than 6 months with ADT. He recommended that I don't, stating that ADT has its own longer-term negative side effects (cardiovascular and bone weakening among others). And this is with a higher Persistent PSA.

Yeah, that's why I'm wanting to see the evidence for 6m v. 9m or longer.
Has anyone on ART/SRT consulted an MO about length of ADT? I'm wondering if an MO might have a better handle on this than an RO.

Saipan Paradise said...
...I'm wanting to see the evidence for 6m v. 9m or longer.
Has anyone on ART/SRT consulted an MO about length of ADT? I'm wondering if an MO might have a better handle on this than an RO.

As you know, SP:

1. There is NO hard evidence on 6 vs 9 months of ADT.
2. Yes, I've seen an MO, and asked the question.
3. Every MD will have an opinion, but a 'better' handle....nope.

Why don't you just get a three month Lupron injection, and see how it goes. No need for committing to nine months, so don't fret about it?

Currently 29 SRT treatments down, 6 to go. Relatively free of side effects except for fatigue from ADT, but another SE has been an issue lately.

We've had several warm spells lately, and I have hot flashes/sweating episodes, especially when in business meetings in warm conference rooms (I control the temp in my office, but not in meeting spaces). Sweat dripping down my face, etc. Even an issue at home during the warm spells. I do much better in cold weather.

Has anyone treated hot flashes effectively, especially the sweating portion?

Effexor and Neurontin are options my RO gave me. Didn't know if one was better than the other for sweating.

Thanks

Cary1963 said...
Has anyone treated hot flashes effectively, especially the sweating portion?

Effexor and Neurontin are options my RO gave me. Didn't know if one was better than the other for sweating.

I take both. Effexor is the more effective, reducing the frequency, duration and intensity of hot flashes by half. Still get them though. Usually I'm good during the daytime, but they start up in the evening. That's when I supplement with the Nurontin.

My RO offered me Megastrol, but my GP did not want me taking hormones due to possible blood clots.

The Effexor has helped tremendously with mood swings from the HT. Previously I was a mess.

Break60 said...
... estradiol patches ... I don’t know why this is such a mystery.

Sounds like a hormone to me.

Skypilot56 said...
Cary- I'm just living with them seems like i get them worse at nite

I second the worst at night effect... Tonight for some reason, my hot flashes have been the worst ever!

I'm sweating perfusley .... maybe it was something I ate? I dunno... but I'm starting to think 6 months of ADT is enough for me... I've gained weight, constantly fighting depression, and just feel "yucky".



Zzarth

I feel like my hot flashes have eased a bit...either they are getting better or I just don't notice as much. Although I do get up to go to the bathroom once a night now. During radiation treatment, I didn't...now two weeks post treatment I do.

just wait SP your turn will be coming! Ha ha. I lost it at my bell ringing the wife kinda started then another couple ladies and a guy then pretty soon all of us were crying. But they were tears of celebrations so I guess that's ok hey? It will be interesting what your psa shows this time.

Larry

Sorry to tell you guys....the 'fun' doesn't start until about a month into Lupron.