So worried

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Posted 22 Jan 2022 at 15:21

Thank you so so much Lyn. Such a detailed explanation and makes so much more sense to me now. Gives me hope too that it could be first scenario, but staying realistic and know more treatment may be needed. Will probably be later in the year before the HT is out of the system so should know more then x

User

Posted 22 Jan 2022 at 23:40

Lyn, can I ask you a question that arises out of your post on page 1 here?

After finishing RT it's very common to have to follow up with up to 3 years of HT. Of course there's psa tests along the way to check for increases plus whether the original treatment appears to have eliminated the cancer or not but if the psa is low or "undetectable" during the HT, I'm wondering what is the purpose of keeping it going. The ADT drugs aren't intended to get rid of cancer, so if they're simply keeping any remnant cancer cells dormant, so what?

I think their might be conflicting professional views here and it could be that extended HT with ultra low psa is simply playing it on the safe side [it would certainly increase 5 year survival rates in an AS way], or there might be some chance that over the extended period of HT there's a chance that some remnant cancer cells might die of boredom, which would make it worthwhile.

Maybe this is unanswerable but given those of us on HT can have several years to contemplate the existential point of extended HT I reckon it's worth discussion.

Jules

User

Posted 23 Jan 2022 at 01:41

When I first joined this forum, 3 months HT prior to RT and 12 months after was the norm. Then a big piece of breast cancer research data showed that the longer a woman is on HT the better - it was found that once she stops taking HT, the risk of recurrence is exactly the same as if she hadn't had the hormones at all. Suddenly, men on here were all being put on 3 years HT on the basis that it improved the chance of the RT being curative.
From memory, I think it was the RADICALS team that then got involved and concluded that 3 years provides no benefit over 18 months and comes with 18 months more side effects and associated drop in quality of life, so we now see far more men doing 3 months HT prior to RT and 15 or 18 months post-RT. The current RADICALS trial is comparing 6 months HT with 2 years - it will be interesting to see what conclusion they come to.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Jan 2022 at 01:44

Just to say, I think a similar trend is showing in breast cancer cases as well. I know a couple of women who were supposed to be on HT for 10 years but their oncos have changed their minds and stopped it after 2-3 years.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Jan 2022 at 02:05

Thanks Lyn. Yes, I guess it does come down to stats and that takes time to gather, like 10 years for a 10 year survival rate but the QOL issues are significant. It sounds, from what you're saying, that taking it out to 10 years for breast cancer made no difference to the chances of recurrence but simply put things on hold. That also sounds like it could mean an extra 10 years of life for those who would have a recurrence but 10 years difficult and unnecessary years of HT for those who wouldn't have a recurrence. I don't know how tolerable the HT for women with breast cancer might be but 10 years is a hell of a long time.

Even with PCa, HT the time adds up. A few months of HT before RT, plus 3 years of HT, plus another ~10-12 months of time to re-start testosterone production and it's getting close to 5 years of a treatment that can cause bone density problems, heart problems, diminished physical ability [apart from Irun 😀], QOL probs. and possibly contribute to a shorter lifespan.

I will be pushing my oncologist for an 18 month span and failing that, making a personal choice to drop it at 2 years.

Jules

Edited by member 23 Jan 2022 at 02:53 | Reason: Not specified

User

Posted 23 Jan 2022 at 11:39

There are many HTs for breast cancer but the most common is Tamoxifen; women may also have Prostap or Zoladex so pretty much the same side effects that men have.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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