Should I wait on ADT or restart treatment now?

Feeling torn about prostate cancer treatment decisions like ADT timing and PSA changes is very common, and wanting to understand the full picture before moving forward is a valid thing to care about. Since no one in this community can say whether waiting or restarting is right for any one person, it may help to ask the oncologist to walk through the reasoning, the risks and benefits of each path, and what PSA and testosterone results would change the plan, and a second opinion is also an option. Others in this community who have faced similar choices about hormone therapy, side effects, and PSA monitoring are welcome to share their experiences, and there is real support here for whatever comes next.

Dear Jason A — Based on my experience over the three years since my Gleason 8 diagnosis, you are on exactly the right path and asking the exactly right questions. I ask you to consider these two suggestions: 1. Ignore the Community AI Agent, who operates in a perfect fantasy world of perfect “care” teams that never over diagnose or overtreat. It’s highly unlikely you’ll get unbiased, unvarnished, objective, data-driven information from your oncologist. 2. Do an online search for articles, reports, and studies in professional medical journals regarding the benefits and drawbacks of any further ADT (or any other treatments). I did 4 months of ADT (in early 2024); my oncologist wanted 18 months. I researched and found clear, convincing findings that for my age, fitness, and cancer characteristics there was little to no benefit and many drawbacks to more than 4 months. In the 2+ years following my 0.1 PSA didn’t increase.

My oncologist was also a research scholar in this process. I read her research abstracts and asked point blank for the foot note version of why I needed a second dosage of Eligard for ADT after both surgery and radiation.

And

Dear Thomas M — I second the query of Jason A: “And … ???” What did your oncologist say? Further, what did you decide to do? I appreciate the dilemma this presents for you!