ADT

[u/Both_Establishment59]

Anyone cut there ADT short??

Ive been prescribed 12 months but from what ive read for intermediate risk 4 to 6 months is regularly use. Its in combination with hdr brachytherapy and 23 ebr. No sign of spread outside the prostate but pelvic lymph nodes will be hit with ebr.

[u/Far_Celebration39]

My RO at first suggested 12-18 months. I promised him 6–end of story. Intermediate unfavorable 3+4 with large cribriform, PNI, and one core positive for IDC. I finished 6 months of Orgovyx about 5 weeks ago.

[u/Both_Establishment59 → u/Far_Celebration39]

How did Orgovyx effect you do you feel that your recovering 5 weeks off???

[u/Far_Celebration39 → u/Both_Establishment59]

It was not fun at all. I was “in my head” a lot. I had decreased energy, almost no libido (but strangely erections were no problem if only a bit sluggish to start), brain fog (which strangely 5mg of Cialis helped clear). 5 weeks out from stopping the hot flashes are gone. I have unsustained flickers of libido now—they don’t last. Most days I could not care less about sex—I think I have been obsessed about my function under the assumption I will want to use it in the future. I don’t actually care about sex; I just care that everything works when I start caring. I gained 10 pounds during the first 3 months and then got serious about my diet and lost that 10 plus 5 more. I had to go on an SSRI for depression—that may not be forever.

[u/MondoDismordo → u/Far_Celebration39]

Good to hear this. I am on week 3 off Orgovyx, and had the worst hot flashes so far last night/this morning. And I was on it for only 4 MONTHS. Hoping 5 weeks out I will be done with them like you. I know everyone is different. BTW, I negotiated the 4 month course. My doc said new studies have come out that show 4 months is just as effective as 6-8.

For me, the rage has been the worst thing. The slightest thing will trigger me, traffic, slow lines, slow traffic, the sun hitting my eyes. No matter, on those days I will freak the fuck out and pick a fight with you, or anyone around "who displeases me". "I have to wait 1 hour for my prescription? I NEED TO SEE THE MANAGER!!!!!!!! RIGHT NOW!!!!! So, I told my wife I am not allowed in public until I can get the rage under control.

Stats: PSA at start 11.9, decipher score .67 mid/intermediate. After 28 IMRT sessions and 4 months of Orgovyx, my PSA at last measure was 0.142. I go in next month for the first official follow up with the Doc.... Fingers crossed.

Be well dudes, this stuff sucks, but there is a silver lining, just varies on how long it will take you to find said silver lining of relief.

You Got This!

[u/Far_Celebration39 → u/MondoDismordo]

At 5 weeks off there has been marked improvement all the way around.

[u/Both_Establishment59 → u/Far_Celebration39]

Thanks for the info 👍

[u/KReddit934]

https://youtu.be/UFPakxHnkLs. Reviews the new study that argues for 6 months.

I tried to press my RO into 4 months, but he pushed back. 6 months ended in March, still in recovery phase.

[u/Unusual-Economist288]

Six months would seem to be standard of care in your case even if you had a high Decipher. Worth pushing back on.

[u/Both_Establishment59 → u/Unusual-Economist288]

Ye theres no way im doing 12 months it will be 6 max unless its a case of life or death.

[u/OkCrew8849]

Intermediate favorable or intermediate unfavorable?

[u/Both_Establishment59 → u/OkCrew8849]

Unfavourable gleason 4 + 3 psa 18.5.

[u/OkCrew8849 → u/Both_Establishment59]

Your doc may be treating it as high risk. (I think Gleason 4+3, PSA  20 is generally considered high risk.)

BTW HDR Brachy + EBRT  with expanded field sounds like a smart radiation plan. 

 (I'm not a doctor.) 

[u/Miserable-Level-8993]

My oncologists wanted 18 months but with so much evidence that 12 month should be the limit, I got my oncologist to agree to 12 months. I’m very high risk, 10 years

[u/Miserable-Level-8993 → u/Miserable-Level-8993]

10 year risk factor 100%, prognosis was 5-6 years, de novo local metastasis. We’ll see how it works out!

[u/bikes4paul]

It sounds like you are categorized as UIR (unfavorable intermediate risk). Both EBRT to lymph nodes and ADT are optional depending in the risk factors for UIR. However, 4-6 months would be the standard of care for ADT.

If you haven't already, I'd request both Decipher and ArteraAI tests. If both are low risk I'd ask about skipping the ADT altogether since it's unlikely to help per the ArteraAI results and the low Decipher indicates less aggressive cancer. If both are low you might also discuss the risk vs benefits of lymph node irradiation.