Taking a break from Lupron

Hi! New guy here.
Rp surgery 6/27/19, psa level of 40 before procedure.
0.4 at three month,then 5.2 in November '19 and down to 0.6 this past week.
Ive been struggling with side effects of Lupron ,tiredness ,hot flashes,depression,all the usual complaints.
So, at check up on Monday i told Dr. I wanted a three month break from injections over his objections stating normal protocol for PC is to continue treatments .
Am I right in my decision or should I go back to get another 3 month injection?
Any one with similar experience taking a holiday from Lupron?

IMO it might be early in the game to be calling for a Lupron vacation. After your RP your PSA should have gone to near zero, on its own that is, without the Lupron. Am I to presume that you have been on Lupron for the past year so that your surgery can heal before you undergo adjuvant RT? Or (another possibility) you're old enough that you don't plan to treat any further and just stay on Lupron til the end? Given no other stats, I'm just grasping at straws here.

I'm still wondering why Salvage Radiation doesn't seem to have been considered.

Vygr, welcome to the forum, sorry you find yourself in this position.
I am with mattam, we must be missing something, as to why you were not offered (or maybe it was offered and you refused?) Salvage or Adjuvant radiation. Are they just assuming because of your PSA of 40 pre-surgery, that there are micro mets?
What was your pathology after surgery? Gleason score, margins, SV, Nodes, extra prostatic extension, etc, positive or negative?

Were any scans done after the surgery?
I'm sure there must be a reason Salvage Radiation was not offered, post surgery, with persistant PSA.

To your original question, there is some controversy surrounding intermittent Hormone Therapy, although my understanding of late is that it is becoming acceptable by more and more practitioners. Anyone correct me if i am wrong.
With that said, i would perhaps seek a second opinion, and ultimately follow the direction of an Oncologist that i trust.

Howard the pills you reference are still a way off in time and since they lower testosterone the side effects that are bothering him are still the same as the injected form.

Vygr55, tell us more about your initial diagnosis. What was the Gleason score and grades, how much involvement was there, how many positive cores, was there ECE, etc. Also, please tell us about any discussion of salvage radiation therapy you have had with a radiation oncologist.

I am not a doctor, but you were high risk at diagnoses and surgery clearly was not curative. If you reject the ADT now, you are giving in to the cancer and it will advance and cause a lot of damage. The side effects of metastatic PCa make those of ADT look like a walk in the park.

I re-read the information. 40 PSA puts you in the high risk category and indicates aggressive treatment. I am amazed that your PSA went up to 5.2 post surgery before additional treatment was advised. Rarely see that. Clearly there was either significant cancer left from the surgery and/or your disease is systemic. If it is systemic, you will need to use ADT, first and perhaps second line, as long as it is effective.

Regarding a vacation from side effects, If you have been on ADT now for more than a year, I doubt that a three month vacation would be long enough for any meaningful rise in testosterone levels to relieve the ADT side effects. After a three month shot it usually takes 4-8 months to recover enough T to see meaningful relief due to the amount of ADT that remains after the period of the last shot. So a three month vacation would mean your next shot would be before you saw side effect relief. My recollection of planned vacations are more in the six to twelve month periods which is basically known as intermittent ADT. Talk to your medical oncologist about going intermittent. However, it strikes me that I’d you are already discussing a second line like Zytiga, that aggressive treatment is indicated, not the more conservative treatment of using intermittent ADT.

I agree with the other comments that you should be assessed for salvage radiation therapy as it is clear the surgery failed. You may have another shot at a cure with SRT, but that probability diminished greatly once your PSA climbed over 0.20. Certainly getting to 5.2 was not in your favor and could be very indicative of systemic disease, despite the clear scans. Due to this and your initial diagnosis I would definitely hav a very well qualified and experienced medical oncologist that specializes in PCa. No need to see your urologist/surgery unless you get a UTI.

Just to reinforce what the guys have advised you! If your psa numbers are all correct why would you even consider going off Lupron? I would be looking and getting an RO and MO team specialized in PCa treatment to consider all of your options. JMHO Larry