Thank you Allen.
Since I last posted, I have consulted with two RO's, one a VERY well known Los Angeles RO and co-author of the RTOG 9601 study, who by the way wrote in his study that his personal PSA threshold for "no" ADT with SRT is 0.5, (my PSA is now .355) and the second, another well known RO who has specialized in PCA for years at a highly regarded cancer treatment center in Pasadena. I was given two very different opinions.
After hearing that I was very concerned about
the side effects of ADT, the first RO recommended 4 months of Casodex plus Avodart with the SRT. After reading later that his study had proven that treatment with two years of bicalutimide improved SRT outcomes, I wondered why he recommended only 4 months in my case. The other RO recommended no ADT with SRT due to my low PSADT and PSA velocity of 15 mos and .01 ng/mo. He also stated that the ADT would mask the results of the SRT. Both ROs highly recommended that my pelvic lymph nodes be radiated as well as the prostate bed.
I have found nothing in the more recent literature that I have read to indicate that Casodex is any better than Lupron for SRT, nor of it is even being used instead of Lupron along with SRT. I did find one member here who posted in his signature that he had 3 months of Casodex during his SRT. However, he also wrote that his SRT subsequently failed.
After meeting with my MO and RO at City of Hope recently I am planning on scheduling the SRT at City of Hope as soon as possible. I am leaning towards taking the 4 months of Casodex. Although my MO and RO are agreeing my sense is that they are doing so reluctantly. After reading all the horror stories about
Lupron I want to avoid it if at all possible. However, I am also concerned that if I do decide on the Casodex, it may not be enough to improve the SRT outcome.
All of this is making my decision much more difficult to reach regarding which ADT if any, to undergo. The delay in my next appointment to July 5 to finalize everything is also not helping with my current state of anxiety.
Any additional comments or recommendations you may have will be greatly appreciated.
Post Edited (Italatin8) : 6/9/2017 11:25:09 PM (GMT-6)