I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Thoughts on treatment

User
Posted 27 Dec 2023 at 22:50

Hi.

with my dads recent diagnosis and starting HRT.  He had retention or urine and has a catheter fitted for a week.  He is now on Tamulosin medication.  Catheter comes off Friday.  He is due a bone scan 6th Jan and still waiting for radiotherapy.  He’s asking me. Can’t I just take the HRT and see how I go. He was grade 8 on the Gleason score and T2.  What are your thoughts on this ?

User
Posted 28 Dec 2023 at 00:52

Can we just be clear. HRT stands for hormone replacement therapy. It is a treatment for women on the menopause. HT stands for hormone therapy and can mean almost anything where hormones are manipulated, including HRT (but never for prostate cancer). 

ADT stands for androgen deprivation therapy, and this is used for prostate cancer treatment. As it is achieved by manipulating hormones it is therefore a form of HT. It is almost the opposite of HRT as you are trying to deprive the body of hormones not replace missing ones. Most people on this forum use HT and ADT interchangeably.

Now me being blunt, in an 80 year old, you only need to hold off prostate cancer for five to ten years. With G8 refusing treatment would probably end in death within three to five years, and not a very pleasant death. RT alone would probably have a 50% chance of a complete cure, and even if not a complete cure would probably set the progression of the disease back by five to ten years, so RT alone is a realistic choice. HT (ADT if you prefer) tends never to cure on its own, it holds the progression of the disease back, but usually fails in about five years, so not really a long enough timescale for your dad.

RT and HT together make the chance of a complete cure about 70%, and if the cure was not complete would set back the progression by about five to ten years, so a better option than RT alone and a much better option than HT alone.

The side effects of RT are not usually very serious, they can be serious but it is not too common. The side effects of HT seem to vary most men find it bearable, but for some it can be unpleasant, if your dad was on permanent HT he would probably get osteoporosis after a few years and then other complications. I suspect he would find after a few years the HT wasn't a great choice, and then it would fail and the cancer return.

In my opinion the RT has the least side effects, and if he is currently coping OK with HT he should probably go for RT and HT together, and if the HT becomes unpleasant stop it after a few months, most of the benefit of HT is a few months either side of the RT.

 

Dave

User
Posted 28 Dec 2023 at 09:14

Dave

I think your analysis would concur with my thinking, although I also defer to your greater knowledge.

Rory

User
Posted 28 Dec 2023 at 15:36
I agree with the others - he is already doing the hard part by having the HT - 4 weeks of RT will give him the best chance of remission and then seeing out the rest of his life playing golf and being active. Although the doctors may recommend HT for 18 months or 2 / 3 years, they can't make him have it. He can stop the HT 3 or 6 months after RT if he finds it is impacting too much on his mobility, strength and energy levels.

If he forgoes the RT, he is basically choosing to stay on HT (with all its side effects) for the rest of his life.

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

Show Most Thanked Posts
User
Posted 27 Dec 2023 at 23:48
Think The RT and no HT would be my option at 80.
User
Posted 28 Dec 2023 at 00:52

Can we just be clear. HRT stands for hormone replacement therapy. It is a treatment for women on the menopause. HT stands for hormone therapy and can mean almost anything where hormones are manipulated, including HRT (but never for prostate cancer). 

ADT stands for androgen deprivation therapy, and this is used for prostate cancer treatment. As it is achieved by manipulating hormones it is therefore a form of HT. It is almost the opposite of HRT as you are trying to deprive the body of hormones not replace missing ones. Most people on this forum use HT and ADT interchangeably.

Now me being blunt, in an 80 year old, you only need to hold off prostate cancer for five to ten years. With G8 refusing treatment would probably end in death within three to five years, and not a very pleasant death. RT alone would probably have a 50% chance of a complete cure, and even if not a complete cure would probably set the progression of the disease back by five to ten years, so RT alone is a realistic choice. HT (ADT if you prefer) tends never to cure on its own, it holds the progression of the disease back, but usually fails in about five years, so not really a long enough timescale for your dad.

RT and HT together make the chance of a complete cure about 70%, and if the cure was not complete would set back the progression by about five to ten years, so a better option than RT alone and a much better option than HT alone.

The side effects of RT are not usually very serious, they can be serious but it is not too common. The side effects of HT seem to vary most men find it bearable, but for some it can be unpleasant, if your dad was on permanent HT he would probably get osteoporosis after a few years and then other complications. I suspect he would find after a few years the HT wasn't a great choice, and then it would fail and the cancer return.

In my opinion the RT has the least side effects, and if he is currently coping OK with HT he should probably go for RT and HT together, and if the HT becomes unpleasant stop it after a few months, most of the benefit of HT is a few months either side of the RT.

 

Dave

User
Posted 28 Dec 2023 at 09:14

Dave

I think your analysis would concur with my thinking, although I also defer to your greater knowledge.

Rory

User
Posted 28 Dec 2023 at 15:36
I agree with the others - he is already doing the hard part by having the HT - 4 weeks of RT will give him the best chance of remission and then seeing out the rest of his life playing golf and being active. Although the doctors may recommend HT for 18 months or 2 / 3 years, they can't make him have it. He can stop the HT 3 or 6 months after RT if he finds it is impacting too much on his mobility, strength and energy levels.

If he forgoes the RT, he is basically choosing to stay on HT (with all its side effects) for the rest of his life.

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

User
Posted 28 Dec 2023 at 21:03
Another agreement. If he is already on HT then that is preventing the cancer develop until he gets RT. There is a claim that it also makes RT more effective. Continuing on HT after radio has a less certain benefit (though many oncologists will recommend it for a period) and at 80 I think the quality of his remaining life is more important.
User
Posted 29 Dec 2023 at 08:06

Tamsulosin affects the brain. My wife said she didnt recognise me on that drug. 

User
Posted 29 Dec 2023 at 09:13

Originally Posted by: Online Community Member

Tamsulosin affects the brain. My wife said she didnt recognise me on that drug. 

She should have stopped taking it then. 😉

Joking apart, Paul, I was on.it for 13 years and didn't have any physical or psychological side effects. My only concern was that it may have masked my true PSA levels. However, it appears that most research suggests it doesn't.

 

User
Posted 29 Dec 2023 at 11:18
As with many drugs, people can react to them very differently. I have been on Tamsulosin for the greater part of 30 years with no discernable side effects. Also, I take Quinine Sulfate for cramp which apparently can lead to Dementia in some cases but so far I don't think it's got to me fortunately, although I do have other non related problems. If you read the small print that comes with drugs there can be a few people that can be affected quite adversely. Where this is obvious fairly quickly, sometimes an alternative can be found but where the effects slowly develop over time one can't always be sure how much change is due to the drug or ageing. Perhaps a good idea to review what drugs you take from time to time and consider whether you are better with or without some of them.
Barry
User
Posted 29 Dec 2023 at 18:30
Taking Tamulosin, gave me a bunged up with a cold feeling while I was taking it - no thank you!
 
Forum Jump  
©2024 Prostate Cancer UK