Relugolix

hunter49

Well I am back after 12 years clean post surgery. I am a 61 year old in shape relatively healthy man and had a robotic prostectomy in 2011. Was good with a very slow rising PSA. Just recently hit .3804 and doctor wants to do radiation and hormone therapy with the Relugolix pills for 4 months. Anyone have experience with the pills and are side effects unbearable? I ha a 4=+3 PSA of 5.4 at time of surgery clean margins no lymph nodes and was perineural invasion positive. Thoughts and thanks

Clevelandguy

Hi,

If it was me I think I would do the radiation and forget the ADT drugs. From what I have seen none of the drugs do more than weaken the cancer but will not kill it. You can always do the ADT after your radiation treatments are complete if your PSA starts rising again. Just my humble non medical opinion to skip some possibly nasty side effects.

Dave 3+4

hunter49

https://csn.cancer.org/discussion/comment/1709219#Comment_1709219

https://csn.cancer.org/discussion/comment/1709219#Comment_1709219

thanks Dave< I am in the same thought process but 3 doctors say do it at least during treatment to weaken the cells. The good thing is this is the pill and if I start to have side effects I do not want I can always stop it. Being 61 and hoping for 20 or so more years the best kill is a quick swift one. Have a let to think on it. My doubling time is 30 months so that is another feather in the do not do it cap.

Old Salt

It would be good to know where prostate cancer was found. Do the doctors assume it's in the prostate bed only or have distant metastases been detected? What kind of scans were used. The PSMA ones appear to be 'state of the art', but there are alternatives.

PS: In general, ADT for 4 months shouldn't give major problems.

hunter49

was on left side of bed only no metastases

Clevelandguy

Hi,

A good article on ADT and associated drugs used.  Of these, only darolutamide does not cross the blood-brain barrier in humans, which may result in fewer central nervous system–related side effects. They are given as pills to be swallowed.

https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet

Dave 3+4

hunter49

https://csn.cancer.org/discussion/comment/1709232#Comment_1709232

thanks read it showed to the doc said it is best for when non metastatic disease becomes hormone resistant

On_A_Journey

I'm familiar with that article too, thanks to researching the side effects of ADT if and when I do get put on it. Out of all the stuff I have come across, it seems to be a pretty concise version of what the differences are between the treatment types, and also gives a good summary of what's in store for the patient. Thank you for posting it, @Clevelandguy .

One thing about it that I do disagree with though is the downplay of estrogen as a treatment option. I understand why it is rarely used if at all nowadays, and it's not just because of the stated cardiovascular side effects, which DON'T actually exist anymore if treatment in the form of Estradiol patches absorbed through the skin are used, instead of via an oral route. It's because of what wasn't said - the feminizing effect on the male body, which most men have a serious hang-up with. Typically, gynecomastia is almost a guarantee (but let's face it, most men over 60 have at least a little bit of it going on anyway). I weigh this against what I see are advantages of estrogen treatment - no bone loss, no cognitive issues, no hot flashes. Given a choice, I'd be pushing for it. Medical castration might be 'better' but at what cost to QOL? But that's just me.