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Five years ago I was diagnosed with GS8 and a rising PSA of around 10. I opted for proton therapy at UFPTI followed by 6 months of HT (monthly shots of Trelstar). For 5 years my PSA stayed at .1 but the beginning of 2016 seen it rise from .1-->.2--.4-->.8-->1.6 a doubling time of around 2.5 months. I've talked to the medical oncologist at the local Cancer Center and they want me to start on Lupron (or Trelstar-my choice). (My T-level is around 200). I asked about doing an ADT2 regiment (like adding Casodex) or even ADT3 (adding Avodart).
He said multiple drugs would only be appropriate if I had very high PSA which indicated widespread metastases. He suspects the recurrence is probably still only in the prostate. His plan would be start with one drug like Lupron and stay on that until it failed and then switch to another like Casodex and use that until it failed. Then try something else.
Is there any studies that show serial ADT is as effective as ADT2 or 3?
We have a few similarities in our PCa histories. Following my initial recurrence: (1) I decided on a Choline Scan at Mayo Clinic to get a better understanding of just what I was dealing with, and I am glad that I did, (2)I opted for "Hormone Lite" with Casodex as its primary anti-cancer agent, and I am glad that I did; it extended the quality of my life for three years.
In any event I have fully documented my experience in an on-line journal some of which you may find helpful: see http://protondon.blogspot.com/
If you decide to take a look I suggest you start with the entry titled "To My Family, Friends and Cyberspace Buddies." I will be available here to answer any questions that may occur to you.
Best wishes Don O.