Hi,
One of the members, Chris J is very much against having HT; read his posts. I very much respect his opinions. For me I think ADT is appropriate, but I am only on it for two years if it were the rest of my life I would consider rejecting it or trying intermittent.
I think your medics will be risk averse and try and keep you on ADT. If you want to change that I think you will have to be quite determined.
If you can say to yourself "this ADT is making my life not worth living" and after you consider the consequences, death (but that was going to happen one day anyway) and you can still say "this ADT is making my life not worth living" then maybe you should come off it.
If you are absolutely sure you want off. You should be able to convince the medics. Chris J gets his counsellor and I think GP to back him up. If they know you have really considered the consequences they will respect your wishes to die earlier but happier.
I know you are only considering a break, but it will probably take your body a year to restore testosterone, and the medics will be worried the cancer could start to do a lot in that time. And if you go in with a half hearted attitude I don't think you will convince them to change your treatment.
This post is in no way trying to say ADT is right or wrong for you but may help you make your own decision.
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User
It is more straightforward than suggested above - it is called intermittent hormone therapy or IHT and is a recognised option for men with advanced disease. However, you may not have quite met the criteria yet - you need to have maintained a very low and stable PSA for at least 2 years before most oncos would even consider it and there has to be a clear agreement about ongoing monitoring. The trick is to be able to recognise the optimum point at which to go back onto HT and then stop again.
The two champions of IHT here have been TopGun and George - in TopGun's case, he survived 14 years. George is like a walking miracle - still. The other person who used IHT successfully was Si_ness but he had very advanced bone mets and was the first person to have early chemo which may have had something to do with his success - he lived for 5 years.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
It's an interesting issue and one of potential relevance to myself. I was wondering how you would know whether you had been put on IHT or whether this is, as is suggested in some posts above, an issue for discussion/negotiation.
My older brother appears to be on indefinite HT - in his case bicalutamide. The oncologist didn't, from what I understand, set out a time limit - it was more "we'll see how well this works and if it stops working we'll try something else."
In my case, undergoing a second course of radio therapy this time to affected lymph nodes rather than the prostate, the oncologist specifically said that I would be on bicalutamide for 2 years.
I guess it pays to find out at the outset whether your HT is time limited or indefinite or intermittent.
User
I have never heard of a man on here with incurable cancer being put on an IHT pathway right from the start; it has invariably been requested by the patient after a few years of successful PSA control. Some oncos have agreed willingly (and even with enthusiasm) while others have had to be persuaded by a determined patient (ref Si_Ness)
You are not a good comparison; firstly because you are on a salvage treatment route and secondly because few oncos select bical for a 2 year stint these days, many preferring Prostap or Zoladex. Your brother is probably not suitable for IHT either; it is usually used with LHRH agonists rather than antagonists such as bical.
Edited by member 23 Feb 2020 at 14:22
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"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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