Discontinuing hormone therapy

Hi MP

I think if me would give it a go, what was your original diagnosis .

Original PSA before treatment, was tumour contained or had it spread elsewhere 

Steve 

Hello MountPeter 

I had 3 years on HT and the lowest my PSA dropped to was 0.29. Once I did my 3 years I had 9 months free of HT before I went back on it. Two things to consider:

* My initial PSA was 182 on diagnosis. (so high on start of treatment).

* My oncologist is thinking "intermittent HT" for me now - we will review my PSA after 9/12 months.

I would think it's a topic you can put to your oncologist - I don't think it would do any harm - only my personal opinion mind. (you can read my journey by clicking on my name or avatar).

Good  luck with this - do let us know how you get on.

Best wishes - Brian.

Any treatment plan is your choice. I know how you feel about HT. I ask occasionally if it’s doing nothing why am I still on it (after three years) but I get the same reply every time… it doing something so keep it up. I’ve got to say that my energy levels are diminished due to lack of use more than chemo or HT. I’m a shadow of my former self. But I’ve yet to be convinced either way. I just keep going for now but I’m only 61.

you do what you think best but if it’s against doctors advice, you can only blame yourself if there’s a detrimental effect.

Good luck dear Mount Peter

My highest psa count was 14. There were two cancer sites discovered. One was contained within the prostate itself and the other was sighted on the prostate wall and was in danger of metastasising to nearby lymph nodes. In the event this had not happened and the nodes did not need extra irradiation treatment.

MP

Ok, am going to assume Gleason was 6 or7.?

If so similar to me, my largest tumour was 13mm near the gland edge.

I would have thought 18 months  - 2 years would have been ok but then obviously I am not an expert.

If it was me I would stop but monitor PSa every 3 months, there could be a small PSA rise when HT is stopped.

Don't forget all that just my opinion.

Also put your ideas to the specialist, see what they say 

All the best

Steve 

Hi MountPeter .  I was originally prescribed 2-3 years HT alongside radiotherapy.  When I was moved to brachytherapy boost (brachytherapy plus full pelvic radiotherapy) it was moved to 2 years. Further research results came in & showed that the intensity of BBoost means that less HT is needed, so - after discussion with my consultant - we agreed on 18 months.   Given your 0.01 PSA, and your 80 years of age, I would certainly instigate a discussion with your consultant.  What have you got to lose?  HT obviously drives your PSA down to “undetectable “ levels, so if you come off it, you will see your ”true” PSA within about 8 months.  If it is high (which I very much doubt) you can always return to HT for a period of time to drive it down again.   AW

Dear AW

Many thanks for your insightful assessment. I am definitely going ahead along those lines. My next consultant appointment is 5 months hence, coinciding with 2 years of HT. I had not realised HT could be stopped and started again if necessary. That is a comfort.

MP

Hi MountPeter , I agree with Alpine Wanderer at age 80, I would take a gamble unless you had a Gleason 9 in which case I might go longer on HT.

I was down for 3 years but stopped at 2 on my oncologists recommendation. My psa was stable at <0.02 while on hormone therapy.

Research on this topic suggests that continuing hormone therapy beyond 2 years does not affect clinical outcomes. Intermittent hormone therapy which improves quality of life with no impact on clinical outcomes is also an option supported by the research.

In your position with undetectable psa while on hormone therapy I would be looking to stop hormone therapy at 2 years and see how your disease responds. If its stable continue without the hormones if you relapse you can consider restarting with no clinical downside. However, you need to carefully balance the impact of continuing hormone therapy on your quality of life with the potential clinical benefits. 

Best of Luck Rob