How long is too long on HT

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Hi, I was diagnosed in sept 22. Psa 10, 3+4 Gleason and T3b….it had spread to seminal vessels, I’m 65 now.

the only option I was given at the time was RT and 3 years of HT (prostap injections).

I completed RT 17 months ago and continue with HT. I have a range of side effects associated with RT/HT.
my last two PSA results where 0.04 & 0.03.

my HT is due to continue until Dec 2025.

I am due to see my oncologist Jan 25.

my question is why do I need to stay on HT for 3 years. Is there any evidence out there (I can’t find any that suggests the longer you are on HT the better. However there is evidence out there to suggest the sooner you can come off HT the better).

I know ultimately the decision is mine but I want that to be an informed decision.

I want my life to return to normal sooner rather than later and if staying on HT for another year will give xxx number of years longevity then that is something I would consider…..but is there evidence out there that would be the case.
when I had my original treatment plan I didn’t have the knowledge and experience I have of PC that I have now but I do remember the consultant saying “ you will have the Gold standard treatment of RT/HT for 3 years”. I didn’t question this but on reflection it seemed to be a one cap fits all treatment and no consideration of how well the treatment progresses for the individual?

Any thoughts

thank you

Grundo 10 hours ago

Hi Brizzy

This gets asked a lot and I think your main issue is the fact that it's in the vesicles as well.

Sometimes I think it's a belt and braces approach which seems to work well if cancer a T3.

Possibly questionable if all stats low through although I realise time on HT would be less.

Length of time is down to type of spread, possibly if just outside the gland then less time on HT but in your case 3 years probably about right although u could query it at the next meeting.

Best wishes

Steve

Alwayshope 9 hours ago

What a very good question. What is the definition of 'long term'? I have found this review which classifies it as 18, 24, 28 and 36 months. The type, dose and extent of RT play their part in the equation but one bit is of interest in that LDR Brachytherapy in addition to EBRT, even for high risk patients, improves outcomes in terms of progression free survival.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8428221/

There has been some work comparing 18 vs 36 months for high risk LOCALISED prostate cancer which shows that the 36 months did not give any benefit over 18 months.

https://pubmed.ncbi.nlm.nih.gov/29980331/#:~:text=Patient%20summary%3A%20In%20this%20study,a%20better%20quality%20of%20life.

One thing to take into account is your initial spread of T3b which is very high risk, although your initial PSA and Gleason might ameliorate this, but your current PSA is very low so maybe you are a candidate for stopping HT earlier than originally planned. Definitely one question for the experts at your meeting in January.

Brizzy1 9 hours ago in reply to Alwayshope

Thank you your reply and the links you have providec

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How long is too long on HT