ADT Treatment Hormone Therapy

Japanman

Hi

I have committed to a programme of IMRT. This started with me receiving Zoladex but I did not receive Flutamide or Bicalutamide. Some cancer veteran mates told me that I should have been on one of these prior to the Zoladex injection to counteract flare. I welcome any advice or comment from fellow prostate cancer veterans or sufferers who have experience of ADT.

VascodaGama

Hi

The typical and common steps in the combination (ADT + RT) treatment is to start with an antiandrogen taken for two weeks before the LHRH agonist shot, and approximately two months later start IMRT. But these may change depending on the conditions and status of the patient.

The purpose of the antiandrogen is to avoid "flare" (a phenomenal surge of testosterone in a short period of 10 days caused by the agonist). It is used when the patient has or had sensation of pain in joints, which could be attributed to metastases in bone.

In your case probably the doctor haven't seen such need in avoiding "flare". However, the agonist's effect which will be "working " during a period of at least 6 months, is the important medication in the combination therapy. The antiandrogen will have no effect at the time you start the IMRT if it hasn't been scheduled to be continuously taken along the period of the agonist.

Best,

VG

Japanman

Thanks , it seems my Dr has dispensed with the anti androgen. There are no health reasons for this. I am 61 and excepting the cancer, otherwise fit. It doesn't make sense.

VascodaGama

Great.

Can you explain what lead you to choose the radiation option?

Newbies will appreciate reading your story.

I recommend you to drink loads of water one hour before each IMRT session to fill the bladder. It helps in protecting its walls.

Good luck in your treatment.

VG

Japanman

Well I think the choice is subjective as both treatments are considered effective. Both have side effects and from my reading these vary with individuals.

I wanted to avoid the knife, anaesthesia and catheters. The radiation treatment, although more prolonged is alleged to have less incontinence issues than surgery. It is also an outpatient thing. The downside is twenty daily hospital visits over four weeks.

I had also read that erectile issues are more likely with surgery than radiotherapy. Although for someone with a high grade cancer like me and likely long-term ADT treatment this will be an issue that I shall not avoid.

It seems that I will be on hormone treatment for two years. Others with low or intermediate grade cancer will be on it for a lot less time. The terms hormone treatment and ADT (Androgen Deprivation Therapy) seem interchangeable. The LHRH agonist drug, in my case Zoladex stops the body producing testosterone, unfortunately this is necessary as the testosterone feeds the cancer.