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When to stop HT before RP

User
Posted 09 Feb 2022 at 12:03

Hi All,


 I have been on various forms of HT for 20 months- initially Prostap, until it failed, then Zoladex and, since 9/21, Bicalutimide as well. The objective was to soften up my tumours ( T2c N0M0; Gleason 3+4) prior to my preferred route of EBRT. After a lot of faffing around, RT is no longer a good option for me, so I am intending to have the op in September this year , after a few previously postponed family events are out of the way. The HT meds have, eventually, succeeded in reducing the production and take up of testosterone, so my PSA is down to less than 1, from a high of 18. The clock has not stopped ticking, but it has slowed down, giving me a bit of leeway on timing.


My question is: how soon before the op can I sensibly stop the HT? For the obvious reasons, I would quite like to start the process of getting my system back to normal as soon as I reasonably can. I realise that the meds tend to remain active in the body for a while , so I am looking for the sweet spot to stop the meds, where the benefits hang around until the op, but ( like good house guests) they and their side effects pack their bags in good order when they are no longer needed. 


I am due a 3 monthly  Zoladex implant in Feb, and again in May- would it be sensible to see that as the last, and to dial down the Bical from June?

User
Posted 09 Feb 2022 at 18:44

Hi Olefogey,


I think this is a question only your medical team can answer.


Hope all goes well for you.


 

Ido4

User
Posted 10 Feb 2022 at 00:33
In normal circumstances, a man wouldn't have been on HT prior to the op so there will be little data out there to say when is a good idea to stop ... in theory, you could stop the zoladex now because it would just put you in the same position as almost every other male waiting for prostatectomy.

However, you did not respond well to HT to begin with and you have the added complication of being on bicalutimide - the risk when you stop bicalutimide is that your PSA might flare. Best to seek advice from the oncologist on whether the bicalutimide should be stopped before the zoladex or after. And I would ask the oncologist rather than the surgeon :-/
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Feb 2022 at 09:29
Hi Lyn,
many thanks.
 
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