Hormone therapy

Hi Anne

That is a good question and one that I have constantly thought over.

Generally speaking the higher the staging the longer the HT is for.

I presume that if escaped the gland , in particular, then perhaps important to throw everything at it but as u say , if RT is supposed to kill the cancer cells then why HT for another 21 months.

I know there are answers but in my mind still questionable.

Don't think that helps u much but just my thoughts, obviously I am not a Specialist or even Dr.

All the best

Steve 

Hi Anne,

I asked this question at a local support group called "The Walnut Club" (I know....)

To paraphrase what I was told, it seems to work like this:

1. The initial stage of hormone therapy stops the cancer advancing, and shrinks the offending tumour and organs, presenting a better target.
2. The radiotherapy is applied. I think of this as a big brother turning up and giving the offending cancer a really good kicking. The cancer dies.
3. Then there is a further period of hormone therapy which, effectively, ensures that any surviving parts are starved.

I believe, but cannot confirm, that the hormone therapy goes on long enough to ensure that any remaining cancer cells cannot divide. 

The more aggressive the cancer, the longer the period of both radiotherapy and hormone therapy.

If I am wrong about this, someone will correct me sharpish.

Best wishes,

Steve.

Hello Ann (Ann33) 

Steve (mstev2) is spot on with his post.

The Hormone Therapy removes your OH's Testosterone which is the "food" for the Cancer cells - if they have no food and the Radiotherapy has "missed them" the hope is the longer period of Hormone Therapy will kill them off. As a T3A I have had 3 years Hormone Therapy.

Here's a link to our details on follow up treatment for prostate cancer which you may find helpful:

Macmillan - Follow Up Treatment Prostate Cancer.

I hope this helps, if I can do anything else for you please do get in touch.

Best Wishes - Brian.

Hi !

By using hormone therapy you supress Testosterone levels in order to starv the cancer cells, make them more sensitive to radiation and create a hostile environment for them to be able to live in.

By being on HT neoadjuvant you also try to make sure that the cancer can’t spread in time for radiation

It’s true that the purpose of radiation is to kill off the cancer. But you can never guarantee that the cancer is killed of by radiation instantly and there might be residuals left, dying, weakend and perhaps also going dormant because of the radiation. You don’t wan’t to give any weakend or dormant cancer cells the chance to recover so, you stay on hormone therapy, in your husbands case, for 2 years to mitigate any risks for any residuals to recover.

Your husband is locally advanced and that’s high risk and with high risk PCa you do salvage radiation and long term hormone therapy with a curative intent and without the HT there is a much higher risk of recurrence

Thank you that has been very helpful towards understanding his treatment plan.

His PSAs have be 0.06 @ 6 weeks post op 0.09  @ 3 months at a different testing centre

0.01 @5 months however unfortunately was put on bilutimide tablets & HT injections roughly for 5 weeks prior to PSA Test, so unsure what it would have been without HT.

Should we expect future PSA Tests to be low considering he has had a Prostatectomy and completed 33 fractions of EBRT we just don't know what to expect .

• Hi my husband had a prostatectomy 3 years ago initially T2b but after the op amended to T3b.  PSA levels for 2 years less than 0.08 which they classed as undetectable and no HT or RT recommended just the 3 monthly PSA tests.  The  PSA levels started to rise and at 0.27 HT and RT now recommended.   Appointment on Tuesday to arrange next steps.  It's interesting that although your OH PSA levels are so low he has already had HT and RT!  There are so many differences of opinion from the various medical teams it is very frustrating and worrying.   

Hello There,

OH urologist arranged a referral to oncologist as PC gleason 4+4 was found in one seminal vesicle.

Oncologist recommended HT & RT as a precaution incase cancer cells too small to be detected were present,so may or may not be there.

Guess each case is so varied as are opinions of cancer specialists..Good news that he has been monitored and that Oncologist is on his case

Best Wishes for you & your OH Tuesday,

Would be interested in how he gets on.

Take care 

Another Worried Wife 

OH was Gleeson 7 and it had gone in what they called the margin.  I thought he should have had the RT after the op but they said not unless readings went up .  As you said different opinions but now we have to start it and he would have been over it all by now.   How did your OH cope with the HT and RT? 

OH has completed 33 sessions of RT main effect is tiredness/fatigue  some bowel issues which started around 1/2 way through RT. Generally other men had 20 fractions so didnt seem to have the degree of bowel issues. He is slowly recovering. He hasn't had too many side effects from HT(touch wood) other than occasional hot sweat moments but has another 19 months to go yet.

Probably due to OH having family history of PC and as classed as locally advanced the decision was made to add further treatment as a precaution as it wasn't expected or detected on biopsy to have escaped the prostate. Better to be safe then sorry i suppose.

RT sessions go quite quickly once your in the system. We used markers such as third of the way through then half way etc it helped speed it along!

Best Wishes

Ann33

Hi!

After radiation and when on hormone therapy you expect correctly; a low PSA level in order to see the efficacy of the treatment

I suppose you mean the PSA went back to 0.01 after your husband went on Bicalutamide and hormone therapy and that is a fantastic result and if the PSA stays at 0.0n going forward that show salvage treatment have been and is very effective.

When having radiation only with the prostate left the PSA can fluctuate before stabilizing. But as your husband have had prostatectomy before salvage radiation the PSA is more stable.