Radiation without Hormones?

JasonB176
JasonB176 Member Posts: 40 Member
edited May 31 in Prostate Cancer #1

In my previous posts I've spoken about only wanting surgery rather than radiation. I've been told by others (non-professionals) that it's possible to do radiation without hormones in my case given that I have favorable intermediate prostate cancer (3 + 4 with 5% involvement of 4 in only one core).

Does anyone know if that's true? All my own research into radiation indicates that you have to have the hormones with it to make the area receptive to the effects of the radiation. I am trying to avoid any kind of hormonal treatment and that's been my primary reason for favoring the surgery option.

Thanks.

Comments

  • centralPA
    centralPA Member Posts: 321 Member
    #2

    From the detailed NCCN guidelines…

    https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf

    • Favorable intermediate risk RT options include either EBRT or brachytherapy. Combination brachytherapy boost with EBRT should not be routinely used. ADT or antiandrogen therapy is not used routinely but can be considered if additional risk assessments suggest aggressive tumor behavior.

    The patient guidelines also say just radiation, no hormone therapy.

    https://www.nccn.org/patients/guidelines/content/PDF/prostate-early-patient.pdf

  • Old Salt
    Old Salt Member Posts: 1,467 Member
    #3

    Yes, thanks central PA; that guideline answers the issue raised by Jason.

    Here is essentially the same recommendation from the American Urological Association:

    In patients with low- or favorable intermediate-risk prostate cancer electing radiation therapy, clinicians should not routinely use ADT. (Moderate Recommendation; Evidence Level: Grade B)

  • JasonB176
    JasonB176 Member Posts: 40 Member
    #4
    https://csn.cancer.org/discussion/comment/1715637#Comment_1715637

    Thanks for that info. I went on another board which for some reason is very pro-radiation and anti-surgery by most of its participants. I was surprised by how forceful their comments were. I guess it's making me question my commitment to surgery especially given the information you just shared. My complete story can be found on other posts but all three urologists I saw strongly recommended against radiation. I know that is somewhat expected but I think the reasoning is sound. I'm only 52 and they said the chance of reoccurrence is higher with radiation. They also said it's better to leave that in reserve if surgery fails. But if I can have it without having hormones mess up my body, I might have to at least meet with a radiation oncologist. I'm an avid cyclist and didn't want hormonal treatment because of its negative effects.

  • bdhilton
    bdhilton Member Posts: 866 Member
    #5

    Jason…As you are finding out, there are no “cookie cutter” treatments for our PCa. I’ve had salvage radiation (post-surgery) and SBRT and on both occasions, hormones weren’t mandated, but I elected to have Lupron for 6 months on each treatment. I understand the hormone concern and it does impact you but for 16+ years (I’m 69 now and 53 when diagnosed) I have enjoyed a great and healthy life even with Lurpon on two occasions…and I’ll be going on to a hormone treatment for a year or so the next big tick up on my PCA…Your treatments are always your choice and if you haven’t, I’d get a second opinion from a recognized medical school…My treatments have been from Northwestern and UCSF…

    All the best-BD

  • Clevelandguy
    Clevelandguy Member Posts: 1,148 Member
    #6

    Hi,

    I agree with the other survivors, I think the doctors want to include ADT but why not do the radiation and then if your Psa starts going up start the ADT. Got to remember the main goal is to kill the cancer and worry about biking later. It’s you and your doctor team decision on radiation or surgery based on your particular case. Second opinions are not a bad idea. What gives you the best shot at getting rid of your cancer, surgery or radiation?

    Dave 3+4

  • Josephg
    Josephg Member Posts: 443 Member
    #7

    Combination of radiation and hormone therapy have shown to improve remission rates and lengths of remission intervals from 16% to 30% for intermediate and advanced PCa, as determined by Gleason scores. But, as always, the final decision is up to the patient, and results can vary.

  • Steve1961
    Steve1961 Member Posts: 605 Member
    #8

    three steps to prostrate cancer step one if it’s confined remove the prostrate get rid of the cancer and have radiation as a back up plan number 2 and then third and last would be hormone treatment. Ask andpy oncologist. The last thing they wanna do is hormone treatment and that’s for a good reason because it destroys a man That’s just my opinion. I did radiation at 57. It didn’t get rid of it all and now I’m 63 and I just had my prostrate removed because unfortunately it came back. All I can do now if it retirns again is hormone treatment because I can’t do radiation twice. That’s just my opinion. I wish I took it out the first time. … I don’t know how old you are but there hesitant about giving radiation to younger men because of the long-term side effects 1015 years down the line it can cause another cancer. Why would you want to take that chance for I totally regret it

  • JasonB176
    JasonB176 Member Posts: 40 Member
    #9

    Thanks for the comments. I've decided to look into the more modern types of radiation like SBRT and the seed type. I'm not interested in going 5 days/week for many weeks but these types don't require that.

    I am in the process of booking with two radiation oncologists from different facilities.

  • Old Salt
    Old Salt Member Posts: 1,467 Member
    #10

    Excellent plan!

    Not clear whether you are including High-Dose Brachy in your evaluation.

  • centralPA
    centralPA Member Posts: 321 Member
    #11

    I've always thought HDR Brachytherapy was the right choice for those who are good patients for it. Quicker, puts the radiation right where it’s needed. The huge improvements in imaging have improved its performance too.

  • Rob.Ski
    Rob.Ski Member Posts: 164 Member
    #12

    I had 2 radiologist, one specializing in SBRT recommend surgery because of my age (51 at the time) otherwise good health. Their opinion was options are better if first treatment fails. That was major factor in my decision for surgery. There are risks either way and it varies by patient what their priorities are. Definitely get as much info as you can and ask about plan B if there is recurrence.

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