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Hormone Therapy 6 mts or go for 9mts??

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Posted 11/26/2013 12:12 AM (GMT -5)
Just saw cancer Dr to-day and will see him again in 6 months.
Originally he said a one year course of HT. To-day, after 6 months of HT [and HDR], He is not pushing the HT as much now. That it is up to me if I want to take the 9 month one or not.
He was also saying we have an option to take the 6th month or not.
He said he can only advise what they know so far and that 12 months is the official recommendation.
They used to give HT for 3 years and then figured they had the same results with 2 years, then that moved to 1 year. Maybe that information will be changing to 6 months???

Dr said that if we want to stop at 6 months we have the option. It was like he was telling us I have an option. If you know what i mean.
It seems my hip and pelvis pain might be from arthritis starting and the HT might be causing it and another shot may worsen it plus i have the mood swings and fatigue. Arthritis runs in the family so it is a concern.
I am of course naturally eager to get off the HT and go back to work too but also don't want to take any chances as I was a Gleason 8.
So we now have options of stopping HT at 6 months, or go one more shot = 9 months.
Does anyone have any up to date research information on HT etc?
Did anyone find their HT side effect worsen from their 6 months to 9 months?

Thank you again for the support and hope you are all doing well
Posted 11/26/2013 12:49 AM (GMT -5)
If it were me I'd go for the extra three months if at all possible. That Gleason 8 (5+3) puts you in a pretty high risk category and every extra month of HT now probably makes a significant difference in your odds.
Posted 11/26/2013 1:09 AM (GMT -5)
Thanks Peter, I guess it is just that they say the HDR and radiataion is designed to kill the cancer. My cancer was contained within prostrate but they ERBT the surrounding area 'just in case'. The HT is suspose to stop feeding any cancer for the last 6 months and srink tumours...so if the treatment is suspose to kill the cancer then why continue HT is my thought. If it is going to come back then it will be when ever we go off the HT in 6, 9, 12 months, so I am still trying to understand how another 3 months make any difference?
Will another 3 months cause more arthristis long term is what i have to weigh up

If i go another 3 months then if anything happened down the road i would have no 'I should of's'. So it is fear that makes me go another 3 months.
If I have worsen arthritist pain after i take another shot, I could have same questions

This PC has a long road of choices, eh?

Thanks Peter for your reply - it is great to talk out options...all options/
Posted 11/26/2013 9:07 AM (GMT -5)
I don't know if it is an option with cost, insurance, etc. but you could talk to your doctor about going to monthly shots. That way if your arthritis gets out of control you would never be more than a couple of weeks away from quitting the active portion of your ADT. It would still take a while to wear off but a one-month shot wears off faster at the end of its month than a three-month shot does at the end of its three-months and both of them wear off faster than a six-month shot.

As for how and why ADT kills radiation-damaged cancer cells (better than just the radiation) I dunno -- good question. I've seen a number of complicated Rube-Goldberg explanations -- radiation damages the DNA of the cancer cells so they can't divide and ADT also interferes with cancer cell division so you have to maintain the ADT long enough for the cells to try to divide at least once. But I who knows? What we do know is that for high-risk cancers repeated studies have found that a bit of extra ADT seems to help.
Posted 11/26/2013 10:59 AM (GMT -5)

canuck77 said...
Just saw cancer Dr to-day and will see him again in 6 months.
Originally he said a one year course of HT. To-day, after 6 months of HT [and HDR], He is not pushing the HT as much now. That it is up to me if I want to take the 9 month one or not.
He was also saying we have an option to take the 6th month or not.
He said he can only advise what they know so far and that 12 months is the official recommendation.
They used to give HT for 3 years and then figured they had the same results with 2 years, then that moved to 1 year. Maybe that information will be changing to 6 months???

Dr said that if we want to stop at 6 months we have the option. It was like he was telling us I have an option. If you know what i mean.
It seems my hip and pelvis pain might be from arthritis starting and the HT might be causing it and another shot may worsen it plus i have the mood swings and fatigue. Arthritis runs in the family so it is a concern.
I am of course naturally eager to get off the HT and go back to work too but also don't want to take any chances as I was a Gleason 8.
So we now have options of stopping HT at 6 months, or go one more shot = 9 months.
Does anyone have any up to date research information on HT etc?
Did anyone find their HT side effect worsen from their 6 months to 9 months?

Thank you again for the support and hope you are all doing well

Been there done that and quite honestly I'm not sure what I would do if I had to do it over again. My Brachy ONCO was the one who convinced me, with data, to go with at least 12 months in conjunction with the Brachy process for the best possible results.
Posted 11/26/2013 11:59 AM (GMT -5)
I agree with Peter. That 5 in the Gleason 8 (5+3) would make me want to continue the Hormonal therapy if the side effects were not too unbearable.

I am on a life sentence with the 5 secondary in G9 (4+5) and so far side effects not too bad since March 28, 2013 start of Lupron 4-month.

Other than making your insurance calculations more complication, going to a monthly shot is probably feasible for reasons Peter stated.

LupronJim
Posted 11/26/2013 12:01 PM (GMT -5)
Thank you - it is great to hear the feedback
Posted 11/26/2013 2:20 PM (GMT -5)
these guys are hitting the nail on the head. you can study HT till you are brain exhausted, and no one agrees. all the studies disagree or are suspect. I am a extreme local 9. ALL my doctors want 2 years to get the best bang for the buck. or the best longest survival percentage.
But everyone is different and respond differently so looking at percentages is useless. I like Dr Gerald Chodak. He is usually very clear. http://www.medscape.com/viewarticle/773144
this is a good article. I am for intermittant because the side effects are sooo bad.
Posted 11/28/2013 12:17 AM (GMT -5)
All great comments , like you said canuck77 you have the option, we all have the the right to direct our own care. All I can say is chose your hammer. Preferably a real big one.:-)) Zoladex for two years 13 months to go, leter rip....hey ya never know....right???? idea
Posted 11/28/2013 1:03 AM (GMT -5)
Sounds like going for another three months is a safer route. If the arthritis gets worse... it gets worse. He is already cutting it down for the 12th month shot so it would be meeting in the middle by doing the 9th month shot. Going to go for the 9th month shot and take some more time off work. Thanks for the support to talk out the options - It was a great help.
We want to wish everyone a very happy holidays/Christmas
Posted 11/28/2013 2:19 AM (GMT -5)
Hang on to to your touque canuck77.
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