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When to start ADT

I just updated my post under Allen Z and my history is there. I am looking for advice/opinions on whether or not to start Lupron. My PSA is 1.9, but actually could be closer to 4 since I take Finasteride. My oncologist wants to start Lupron at 4, but I don't want to. I completely understand that there is no standard, gold or otherwise, as to when to start the protocol of ADT, just wondering if anyone has come across any current data on the subject. I of course have searched the web and have come up the usual non-answers--I am not being cynical, it's just the nature of the disease I know.

Thanks,

Allen Z

Re: When to start ADT

Allen not,

Just a layman's opinion, but I would say Finasteride isn't cutting it. I had similar experience way back. It seems to me that ADT, Lupron or Zoladex, is inevitable and maybe something stronger after that, depending how things go. You know the rule - there are no rules with PCa. You can only take the best advice your oncologist has to offer, use your best judgement and do what you think to be right. Have no regrets. Don't look back. Work out how best to survive. Most of us on this site are survivors. That is what the future holds.

I wish you luck with your further treatment. You have lots of options ahead and more will emerge as the years roll by. Enjoy them!

OC in England.

Re: When to start ADT

All:

Thanks for the feedback. I am thinking that I will stop the Finasteride and see what the results are at my next PSA/Dr. visit in June. I was hoping to make it till 65 (will be 64 in May) before starting the Lupron but I guess God has other plans it would appear!

Thanks again,

Allen Z

Re: When to start ADT

Allen Z:
I have just completed a lengthy and stressful research effort to determine a course of action following failed PBRT and a failing Casodex/Avodart protocol. Rather reluctantly I had pretty much settled on intermittent Lupron to be initiated when my PSA reached 7.0 (it is currently under 1.0). Along came a serendipitous reference to Xtandi. This drug will be replacing the Casodex in my "Hormone Lite" protocol prescribed by Dr. Myers roughly three years ago. A brief summary of my research effort will soon appear in my ongoing, on-line journal; see http://protondon.blogspot.com/

Re: When to start ADT

Allen,
I am in a similar place as you. I, like Don O, have failed Proton Therapy and now after 5 years of remission have a PSADT of about 4 months with a current PSA reading of 2.6. I had thought about starting ADT this summer when my PSA reaches in the 6-8 range but I recently ran across a study done by the Harvard School of Public Health and UCSF which says you might delay starting ADT. I've been on Trelstar in the past and am not looking forward to ADT again. Find the study at:

https://www.cancercommons.org/knowledge-blog/androgen-deprivation-therapy-to-wait-or-not-to-wait/

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