I am a 69 yr old white male, diagnosed in Feb 2008. My prostate is 1 1/2 times normal size and I have gleason score 8.  I took Lupron shots and had IMRT.  My oncologist told me to stay with the Lupron shots for 3 years.  If the ADT therapy fails my Doc said there was no alternative therapy.  16 months out my PSA is 0.2.  I am awaiting more psa results this week.


There are so many things wrong with this that it is hard to know where to start. First, there is no reason to recommend three years of continuous Lupron. There is no credible evidence that treatment of that duration offers any advantage. On the downside, continuous hormonal therapy can increase the risk of heart attack, stroke or diabetes unless patients are very carefully monitored and treated aggressively if problems develop. Then, sixteen months out from IMRT and on continuous Lupron, the PSA should be undetectable. I am very concerned about the implications of your PSA of 0.2 ng/ml. Finally, it is really nuts to say that there are no treatment options after Lupron fails! There is second line hormonal therapy and there is chemotherapy. To be specific, there is Casodex, ketoconazole, estrogen, taxotere and mitoxanthrone just off the top of my head. I think you need to get a second opinion to understand how these issues might be tailored to your care.