Radiation alone or with Hormone treatment decisions

Hi 

I went down the route of RT only.

Important for stats to be low, looks like your OH ok.

Having said that they do seem to include HT as a matter of course  these days , my treatment 2017, not sure why.

Could be difficult to go ahead without HT if that's  what they are saying but u could query it.

Best wishes

Steve 

Thanks so much will ask the question

Hello Youie A warm welcome to our little "club",

That's an interesting question and as far as I am aware (I have been wrong before!) I think nowadays they almost without exception give you HT along with RT.

Speaking for myself the side effects of HT aren't too bad and are controllable. As a personal view I am happy being on HT for the full 3 years too as I want to see the back of this cancer.

With your husband's scores on the doors I would think HT would be 18/24 months at maximum but that's purely an uninformed guess.

Don't forget - write down a list of questions to ask the oncologist at the meeting and keep us posted as to how you get on.

Best wishes - Brian.

Thanks Brian my husband already has heart issues and a stroke last March I’ve read HT  can exacerbate these which is why we’re worried.

Hello Youie, sorry to hear about your husbands diagnosis. The good thing is that it seems to have been caught early!  

your question is interesting! I think there are two things to consider:

im not sure where you live and what the waiting lists are for radiotherapy. Where I live, the waiting list has increased this last year from 3 months to 6 months. I vividly recall the prostate cancer nurse telling my husband that with the first hormone tablet ( normally 28 days of tablets with injections starting on day 14) the cancer ‘stops now’ in its potential growth and spread. That’s very pertinent if your husband is waiting a long while for ht!

the second point is that in low risk cases the ht is only needed for 6 mts. My husband (T3a N0 M0 Gleason 4+3) has been told that intermediate cases, such as he is, have not been as well researched for the length of time needed for HT compared with low risk (6 months) and high risk (2-3 years). He has been advised to stay on it for 18 months. 

As I understand it, the RT kills off the cancer cells and the HT stops the cancer cells from reproducing and spreading. From this, I have concluded ( perhaps incorrectly?) that the ht post radiotherapy stops any cancer cells not killed off by the rays from replicating. That led me to question how long the cancer cells live. I was told, ‘that’s the million dollar question!’

the oncologist told us that there is a constant debate about how long somebody should take ht and it’s a question of balancing side effects with the quality of life. He also said that the RT +ht route is a one and only chance for complete cure and to discontinue too early and let the cancer survive is not what anyone wants. My husband will be taking it for 18 months but could have stopped after 1 year. If the cancer regrows then it is, apparently, ht for life.

obviously, no two cases are the same and oncologists seem to differ in opinions across the country. As ‘mere mortals’ we have decided to take the oncologist’s advice on all of this.

. hth and good luck

Hello Youie MY HT is Decapeptyl and I am on 6 monthly injections.

From what I have read the only issue with the heart is you are more at risk of a heart attack /stroke if you don't exercise and let the weight pile on as id does or can do with HT.

To be 100% sure I would check with the oncologist.

Best wishes - Brian.

Hi Youie

I too want to avoid HT if I can, so your question is of interest.

Are you aware that there is a recent new protocol for a 5-day course of RT without HT being slowly rolled out across England?  The Royal Marsden was involved in the research.

Androgen deprivation therapy combined with radiotherapy for intermediate-risk prostate cancer is still a matter of debate.  There have been a number of papers and meta-analysis on the matter.

Dr Mark Scholz an American oncologist has produced a few videos on RT with HT.

D

Hello Dedalus and Youie 

Whilst I can understand where you are both coming from and wanting to either delay or not have Hormone therapy please remember:

* Although Prostate Cancer is a slow growing cancer things can change. My original diagnosis (January 22 was a Gleason 7 ) from a Prostrate Biopsy. Revised diagnosis November 22 was a Gleason 9) from chips taken during a TURP operation. .

* There is an absolute mass of information available on video from America, on You Tube and Mr Google. Here in the UK I find information from Prostate Cancer UK and MacMillan to be more trustworthy.

Don't forget the above are both my own personal observations and I fully respect your personal choices in your treatment.

Best wishes - Brian.

Thanks again Brian

• Thanks D I’ll check the papers out. I know I read yesterday that ADT can cause resistance and the hormone can as rogue in another area causing cancer 18-24 months later. Check out the role of melatonin in PC very interesting but of course be years down the line if at all! Melatonin is really cheap so big pharma wouldn’t be interested in funding research!