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Re: Lingering effects of ADT?

I think it is important to bear in mind that Dr Walsh is a surgeon, not an oncologist and has demonstrated over the years that as far as he is concerned, the only reaction to a diagnosis of prostate cancer which is “curable” is surgery. The fact that most “curable” tumours probably do not require immediate treatment does not feature in his world.

So anything he says should be viewed through this lens.

There is ample evidence that the reaction of men to ADT (Androgen Deprivation Therapy), including the time it takes to recover from the effects of the treatment is widely variable.

Re: Lingering effects of ADT?

Before I was able to take place in the Abiraterone Acitate plus Prednisone Trial, I was asked to cease taking Cosidex, which I had been taking for approx 3 years. It took 3 Months to flush the cosidex from my body enough to start the Trial. I have been on Lucrin (Lupron) for almost 7 years and I was told to continue to have my 3 Monthly shots, whilst on the Trial. I know that the Cosidex has mostly gone, because the side effect of very sore nipples, has now ceased and they are are back to normal.

But as Terry has pointed out, we are all different and also the amount of time you have been on the medication could possibly have some effect on how long the medication takes to be flushed from their system.

Re: Lingering effects of ADT?

Here is my understanding of what is going on. Both Casodex and Zoladex clears the blood in a few days. The effect of these drugs can last forever but the LHRH is typically a year (after 2 years use) and Casodex seems to be about 3 months (from the above comment). These drugs act by filling the receptor sites and then will detroy them. Your body has to regrow these receptors, if it can, before your testosterone will start to go up in level (LHRH) or the testosterone can be made use of again (Casodex).

Re: Lingering effects of ADT?

At age 56 and after 2 years of Lupron, my testosterone level began to rise 6 months after cessation of the drug. By one year after cessation T levels were normal. The "no rules" applies again. I'm now 57 and still have some soft tissue damage from the radiation but judging by my other "symptoms", I am one of the lucky ones although the use of ED medication definitely improves the experience.

My understanding is that it takes at least 3 mos. after cessation for the pituitary gland to start stimulating the testes to produce testosterone and T level is totally unpredictible depending on the individual. - p (Alaska, USA)

Re: Lingering effects of ADT?

Many thanks for your comments. Overall, I am inclined to think that the good doctor meant well but, in this instance, has probably got it wrong.

My own experience, combined with the comments I hear and read from others, leads me to believe that testosterone levels will usually take some time to recover following the end of ADT. On the basis that lowered testosterone will, in most cases, have a limiting effect on tumour growth and probably on PSA readings, it seems likely that these two things may be affected for some time after the end of treatment.

Jeremy

Re: Lingering effects of ADT?

Hi Jeremy,
Hope you're well. My Casodex has led to very sore nipples. My surgeon said that even after I cease Casodex (some time after my HDR and EBRT) I can expect 3 months before the side effects go. Thereofre it's reasonable to assume, as you've done, that the lowering effect on PSA may also continue for up to 3 months.

But don't let that diminish your enjoyment of very low PSA for a man with a largely intact prostate!!

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