This article was published in Oct 2018, about
a study from Sept 2018. It's something of a meta-analysis, a study of other studies. As in some other recent articles I've shared here, we're learning that the G9/10 cases (Gleason Grade Group 5, or GG5) are not
the same as G8 (Grade Group 4, GG4). The practice of lumping G8-10 together has been possibly misleading, by disguising the unique character of the relatively rare G9/10 cases.
There's been so much emphasis on shortening the sentence on ADT, 3 years, to 2 years, maybe 18 months. Some grades do well with shorter courses of ADT, but this study indicates the contrary may be more appropriate for GG5. It's kind of appalling really; imagine the docs saying, "Sorry, it's Gleason Grade Group 5, so permanent ADT for you.'. Then other treatments, but all on a foundation of permanent ADT. Permanent, right from the outset.Prolonged ADT may improve survival in high-Gleason Grade prostate cancer
From the article:“In this study, we found that — at least in the setting of these large, practice-changing randomized trials — survival endpoints were only improved for patients with GG5 disease who received lifelong ADT, rather than short-term or long-term ADT,” Kishan said.
Here's a link to the more academic version of the study, at least its abstract:Association of Gleason Grade With Androgen Deprivation Therapy Duration and Survival Outcomes
55@Dx on 4/16/13. PSA 5.2, G9(5+4), PNI+, cT3a by MRI.
IGRT - 44 sessions (79.2 Gy, 50.4 Gy pelvic)
ADT2 - Lupron+Casodex (5/13-3/16)
8/13-5/16 <0.1 (ADT2)
5/16-3/17 recovering from ADT2
3/17-7/18 ~ 0.6 - 0.8 (no TX)
10/18 = 1.0My Story