And it's not over...

Just met with a radiation oncologist at MD Anderson and since the cancer is outside the capsule with a positive node they want me on HT (Luperon) followed up with IMRT. I was anticipating ART but not HT, but after listening to the Doc, HT was a no-brainer. He said HT is a known and well proven protocol for cases like mine and just ART is not that effective for a single mode treatment.

I wasn't thrilled with the idea of HT after reading about the side effects but the Doc quickly convinced me it's by far the most effective modality with a follow-up of ART.

So I am now a host to a six month's supply of Luperon and will be starting ART early November.

John,
I agree that 6 months is very doable. It will be over before you know it. Walk regularly or whatever exercise you like, but it will help. Side effects will wane within 6 months to a year after you finish treatment. It gives you a better chance at killing the beast, so go for it.

Regards,
Kris

Yeah - ART is much more effective if you are ADT as well. While the side effects are annoying they are a small price to pay for the potential of a cure. 2 & 1/2 years ADT so far here. No more chems for now, but my T and PSA are still undetectable. Keeping my fingers crossed.

I must admit that the perspective from a neutered POV is very novel and often entertaining.

Thanks for the encouragement fellows. I plan on staying very active so that should help deal with SEs. I'll be starting ART early November for 30 sessions so hopefully this will all be over by the end of the year.

Maybe I need something to worry about today or maybe not but I'm reading your signatures and stats and they are so similar to my husbands. His doctor did not suggest any further treatment beyond surgery. Can anybody tell me why? Should we be asking why we aren't doing HT ?

I'm wondering why radiation was never introduced or discussed. Was it because there was no node involvement?

Teacher Lady, I am a high risk of BCR because of + margins. Anyone with +SV, +LN, + margins or +EPE is clinically high risk of BCR. The question is whether or not this means that there is a high risk of metastasis. It doesn't always correlate. A test that my doc uses to help determine whether metastasis will occur, (requiring SRT), is the Decipher test. Based on gene analysis they can calculate probabilities of metastasis within 5 years and help determine whether additional treatment is needed now or later. My Decipher risk is low, so they didn't recommend any additional treatment at this time. I'm to remain on AS (probably for many years to come) until things change. My doc uses a .03 psa point to recommend SRT. He also told me that if I was Decipher risk high, he would've recommended STR right away. Even with an undetectable psa. No waiting for a BCR. This approach seems consistent with the docs for John_TX at MD Anderson.