Hello foges11. I'm replying to share info and hope you continue to do same.
As a reminder, following my prostatectomy the biopsies showed the cancer had extended into my right seminal vesicle. I first saw a radiation oncologist who then referred me to a medical oncologist since radiation was out of the question. I met with Dr. Wee, a medical oncologist at Cleveland Clinic, this week. He agreed radiation is not for me, but he also said that ADT is usually prescribed following radiation treatment, sort of a one-two punch, and not used solely. However, because of my j-pouch we're in a grey area and there's little documentation on the use of ADT alone. He says I am at "high risk" for metastatic disease. In his opinion, I have three options at this point:
- Start ADT for a couple of years, although he doesn't know if two years is enough or even if it will help. Continue to monitor PSA.
- Wait and watch to see if my PSA level continues to go up. If it goes up a little, we can potentially delay ADT somewhat, but if the PSA goes up a lot, we would start ADT now. This is the option he recommends.
- Wait and see if I develop metastatic disease and if so, we would have to use at least two agents at that point.
I had another PSA test this week which showed a slight increase from two months ago. I am waiting to hear back from Dr. Wee with his recommendation.
Yes, I am anxious. I feel like I'm doing everything I can to be smart about this but I really need some good news. For anyone reading this, any thoughts or experience you can share?