Posted 3/29/2015 5:00 PM (GMT -7)
Sorry you find yourself on this path, it's not easy, but you can do it with patience and determination.
The hot flashes vary a lot between people, some don't even notice, and some get them pretty significantly. I'm in the latter group, and take Megace to help. Some have said clonidine (a blood pressure med) helps too. With no help, I get about 6-8 perspiration-inducing hot flashes a day, and 3-45 a night that wake me up. I have serious fatigue too, needing about 9 hours sleep at night, and a 1/2 hour nap mid-day. It's pretty challenging, really!
I've been on Lupron and Casodex for almost 2 years now. Just last week, my MO recently strongly suggested I stick out the full 3 years, though I was hoping for a shorter sentence. This is my primary therapy, being treated with curative intent, and we'll do the max the first time. Maybe, 10 years from now, we'll find that 3 years is indeed too much, but those data don't exist yet.
Others will argue this point. Especially recently (2013) an ASCO presentation by Dr. Abdenour Nabid suggests that 18 months is just as good as 36 months. Maybe this will hold up, it's certainly compelling. The group involved contained T3-T4, OR PSA>20, OR G>7. This is a fairly common description of a high risk group.
It's hard for me to accept that a metastatic T4 is the same risk as say a G7 with a PSA>20. Maybe it is. I don't know, it just seems the cohort is broadly drawn. Also, is the distribution of all those types the same between the two arms of the study? Also, I'm a T3 and G9, so what does that do?
If I decide to bail sometime yet before the full 36 months, I have no real assurance or data that says I'm making the right decision. Welcome to the Twilight Zone of prostate cancer!
Hang in there, hang out here, lots of knowledgeable folks here!
Bx: 6 of 12 pos, G9=5+4 (80%, 60%), 4+5 (2 at 100%, 80%, 10%), PNI+
cT3a (3T MRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex 5/1/13
Post: (age now 57)
<0.1 PSA (ADT2 and post-RT): 8/13, 11/13, 2/14, 5/14, 10/14, 11/14, 3/