Intermittent Hormone Therapy for Prostate Cancer 101 | Ask a Prostate Expert, Mark Scholz, MD

[@johnhazelton7510]

Thanks so much for this. I’m starting a holiday tomorrow

[@johnhazelton7510]

Yes, talked with my oncologist and we are going to take a holiday and checks every three months. I’m thrilled beyond imagination

[@harshaparpyani3653]

Holiday.. till when?

[@jav8r]

@@harshaparpyani3653 I was to have my Lupron last week. We are going to withhold it and wait and see if testosterone recovers and if so if my psa remains at nadir or rises. If psa is good I’m essentially cured, if psa starts to rise then we’re back on until it’s no longer effective. Says it’ll take 6 months to a year for testosterone to recover if ever and once it does holiday could be a little as 6 months if psa is rising or maybe as long as 3-5 years or longer if it doesn’t. I’m need off this Lupron, it’s been 2 1/2 years and I’m not nearly the same guy I was before. This sounds wonderful to me.

[@robwells230]

​​@@jav8rYour testosterone may never return to baseline. That toxic ADT CASTRATION leaves us with low T probably forever. Doctors , even Dr Scholz never warn us about the horrific quality of life destroying and life shortening side effects of this ADT CASTRATION. I am trying to get TESTOSTERONE REPLACEMENT THERAPY to bring my very low T level back up after just one six month shot of Eligard, but doctors refuse to prescribe it. I am going back to Mexico this fall and intend to get Testosterone there over the counter and self inject to try to regain some semblance of quality of life. We need to demand BIPOLAR TESTOSTERONE therapy so we can ensure that our T recovers , and stay on T until PSA rises to 5 or 10 before further ADT. That way, we can reclaim something resembling a decent life and not suffer our final years as ZOMBIE EUNUCHS. Good luck

[@airbrushken5339]

As a Vietnam combat Veteran (2/502 Inf 101st Airborne) who has prostrate cancer, the hospital doctor (I didn't pick her) increased the radiation levels for 5 weeks (25 days) plus Hormone injections ( kzbin.info/www/bejne/jYCrgaiPbZ2Fr5Y ) .... on my last visit she said my PSA level was almost nil (!) but to be safe she gave me this new injection that was to last six more months to be safe? It left me with one hell of a lump on my bottom and now, over 2 years have past and I'm still sweating ALL the time day and night, no sex or offer of any medication that may help me. I asked her what we could do and she said well it could just be my PTSD (?) I was a team sniper in the war ... I have dreams and memories which I've learned to deal with many years ago, but sweating like mad, I don't think so ... it was obvious she knew nothing about PTSD or veterans. I saw her 3 more times ($240 a pop) and not once did she offer any form of relief or advise ... so I stopped going to"GenesisCare" (Hurstville, N.S.W. Australia) they are a world wide cancer clinic started in Queensland, Australia in the early 2000's.... I asked my Doctor; "if she could ask another specialist to maybe help her with my issues" (she's quite young and knew nothing about the Vietnam War, Veterans and Dioxin Poisoning (Agent Orange) ... She was insulted ... I'm alone, and still suffer ... I thought how would my life been if I had done nothing ... I don't smoke, drink and I'm quite athletic, including my 45 minute walks every day. With this new, peripheral neuropathy, those walks are now over. I'm guessing an "Angle Flight" is my only option. There is no cure or anti-poison pill for "Dioxin Poisoning" ... I have lost 11 very close fellow VN Veteran friends to prostrate cancer and 3 others who took their own lives after they found out they had it! ... Around 400,000 Vietnam Veterans have died since returning home from the war only to have these strange illnesses end their lives? >>>> Trust me, other than one's family, NO ONE CARES! NO ONE ... I did everything my country asked of me as a patriot, like my father and grandfather did before me, as they told me; "it was part of what being an American Citizen, even more ... yet I'm dying alone ... I often find the term "Quality of life" missing at private (for profit) clinics. I watched my father suffer through Chemotherapy ... he complained of tingling, burning and weakness or numbness in both his hands, feet. He was so weak, sore, tired, plus achy muscles and loss of his full head of thick white hair. Yet they kept treating his incurable disease at a high monetary rate ... why, which part of those lines of text refer to Quality Of Life? Why not load him up with some high dose opiates and just let him rest and talk to his kids and grand kids???? >>>>>>>>>>>>>>>>>>>>>>NO>>>>>>>>>>>>>>>>>>>> It's about generating income for the company and stock holders. Shoving a breathing tube down your throat and a feeding tube, plus the drains isn't living!

[@JohnJIvory]

Yet another fantastic presentation. Thank you! I'm especially intrigued that people neither live longer nor shorter using intermittent rather than continuous therapy. I'm interested in getting citations to these studies to discuss with my GU med onc. Will send a message to your help line.

[@JohnJIvory]

I had a warm fuzzy feeling during and after watching this video; not so after contacting the PCRI help line. Dr. Scholz mentioned a study in the video; he clearly seemed to have (a) study(ies) it top-of-mind. I sent a message to the helpline asking for a citation (a simple name or principal investigator would have done). Their reply? "We don't really have the man/woman power to do the research for you. You can use google to research these studies." An insulting reply to a simple question.

[@ThePCRI]

Hello Mr. Ivory, our apologies and thank you for letting us know about this experience. We will look into this and rectify the matter. Here are some of the links Dr. Scholz mentioned in the video. We hope this is helpful. A phase III randomized trial comparing intermittent versus continuous androgen suppression for patients with PSA progression after radical therapy: NCIC CTG PR.7/SWOG JPR.7/CTSU JPR.7/UK Intercontinental Trial CRUKE/01/013. | Journal of Clinical Oncology Klotz. L | ascopubs.org/doi/abs/10.1200/jco.2011.29.7_suppl.3 SWOG-9346, Hormone Therapy in Treating Men With Stage IV Prostate Cancer - Full Text View Southwest Oncology Group | clinicaltrials.gov/ct2/show/NCT00002651 Randomised prospective study of intermittent versus continuous androgen suppression in advanced prostate cancer | Journal of Clinical Oncology Miller | ascopubs.org/doi/abs/10.1200/jco.2007.25.18_suppl.5015

[@mperloe]

Dr Friedman from University of Chicago published an article in 2016 suggests that low T promotes apoptosis while aromatization of residual androgens to estrogen can be mutagenic. What is the genesis of CR? Could it be estrogen and exposure? If so would an AI such as letrozole during the intermittent T break reduce the risk of CR?

[@ThePCRI]

Mark, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@mperloe]

@@ezarizaehsan9201 I’m riding my Peloton almost every day.

[@tonyzayner-hp7sy]

You guys are simply awesome.....Doc your explanations and confidence helps calm my fears in this journey

[@maverickat4544]

Thank you so very much for that!💜 My urologist suggested a holiday from my hormone therapy starting next year Jan after a full year of hormone blockade. My PSA is now at 0.01. Was feeling a bit insecure about going off a treatment that is saving my life. This video has given me the confidence to take a break from the Lupron & bicalutamide early next year. Thank you again🤗

[@davisjohnson472]

I was diagnosed of CANCER in 2016 and I have tried all I can to get cured but all to no avail, until i saw a post in a health forum about a herbalist man who prepare herbal medication to cure all kind of diseases including CANCER, at first i doubted if it was real but decided to give it a try , when i contact this herbalist via his email and he prepared a CANCER herbal cure and sent it to me via UPS delivery company service, when i received this herbal cure, he gave me step by directions on how to apply it, when i applied it as instructed, i was totally cured of this deadly disease within 21 days of usage, I am now free from the deadly disease called CANCER, all thanks to Dr. Ayemere you can reach this great herbal doctor via call or WhatsApp him [phone] or email doctorayemereherbalcure@gmail. com He also have the herb to cure: (1) ALS, (2) DIABETES, (3) HIV&AIDS, (4) URINARY TRACT INFECTION, (5) CANCER, (6) HERPES (7)HIGH BLOOD PRESSURE (8)fibroid (9)Pregnancy (10)Tubes block(11)kidney disease (14)Heart failure (15) S.T.D

[@harshaparpyani3653]

Holiday? For how long?

[@robwells230]

You might be getting a break from the ADT, but the chemical castration effects will continue for many months, years, or forever. Up to twenty percent of older men NEVER RECOVER their testosterone levels above castrate level after ADT, but doctors and drug manufacturers don't want you to know this. And good luck getting any doctor to put you on testosterone replacement therapy. I may have to buy it over the counter in Mexico and self inject, if my T level doesn't recover. ......You need to realize that you are getting concentration camp treatment, not patient centered care or shared decision making

[@johndefenderfer5946]

Personally, I dislike the word cured when it comes to prostate cancer. If anyone should have ever been declared cured it should have been me given my really nice PSA test results I had after my surgery and radiation treatments now 13 years ago. Fast forward to now and I am going through a stage 4 recurrence and not much caring for hormone treatments; but it is doing its job and I can't argue with that.

[@WastePotato]

@@johndefenderfer5946 That really sucks. My thoughts are with you.

[@williammitchell6921]

Another excellent interview. Great questions and great answers! Thank you!

[@jonathandaines6840]

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[@guyshirra824]

Once again, a tremendously helpful video; thank you.

[@Prog-t9d]

Terrible side effects. Fatigue, mood swings, muscle loss.

[@edabreu7871]

Why do these shot need to be administered in the abdomen? It feels like heavy hot lead in my belly. I am getting to the point where I can no longer tolerate the pain of these shots.

[@bayfilly1]

Thanks for all your videos ! A few times Dr Scholz mentions a vegetarian diet for prostate cancer patients. But is there really any subjective, empirical scientific evidence for this recommendation? My grandmother always said tomato sauce on my spaghetti would prevent cancer, but this was just anecdotal folk theory. Hoping you might provide some references for your suggestions.

[@gavinfoster9118]

Another great video.Thankyou so much to both of you!

[@andyh7522]

A very informative video as usual but I would like to know whether intermittent hormonal therapy can be tried in metastatic prostate cancer.

[@andym74]

Exactly

[@13Hangfire]

Thank you for all the work you do:)

[@ernestovillarin7404]

I was diagnosed with High Grade Prostate Cancer, Gleason score 7 that has gone outside to the seminal vesicle 1 1/2 years ago and have been getting Lupron shots every 3 months with a total of only 4 shots because I had canceled a couple of appointments. My PSA has gone down from 11.45 to 2.45. I had a CT scan, without and with Contrast and a Whole Body Bone Scan, both without any evidence of metastasis. I sent an email to my urologist asking if I can have the PSMA PET-CT that I learned online can detect cancer cells anywhere in the body. My urologist has not responded to 3 emails I sent in the last 2 weeks. What advice can you give me? Your response will be very much appreciated. Thank you Dr. Sholz.

[@parkland4530]

How long should it normally take for ones PSA levels to become undetectable following Hormonal and Radiation treatment?

[@spanky1998]

Excellent information. Thank you.

[@gvet47]

So what does Lupron do if the your prostate cancer has spread to your lymph nodes? I was told the cancer cannot be cured.

[@sayedgoda2099]

All your videos are great educational and very useful. Thanks

[@pavlo687]

Dr. Scholtz, when talking about robotic surgery, talks as if erectile dysfunction is a given. So, my question this... Is his answer the same with a good surgeon who does nerve sparing? How much does he think this would increase your odds of remaining potent longer (I'm 71 now).

[@ThePCRI]

Hello, our helpline would best be able to help you with your question. You can find our contact information here: pcri.org/helpline

[@mohamedadel-bh1qg]

Age 74 having prostate carcinoma highest PSA level was 35 after using horomone therapy decreased to one after 4 months of horomonal therapy after 6 months begin to rise again reaching 5 mg when to repeat horomone therapy or must use another treatment options

[@alcameron6071]

@@mohamedadel-bh1qg i’m 74 years old and I was just diagnosed last week with prostate cancer. I have been binging on information videos online and on the Internet and I am frantically looking for a suitable treatment. Operating to remove the prostate is out of the question. Not even thinking about that. I don’t know about you but at my age I am still pretty active in the bedroom in the thought of not being able to get an erection or carry on with my sex life as it is is something I’m not prepared to deal with. It’s one of the few joys I have left in my old age and I simply am not willing to give it up. Did you initially go with hormone therapy above everything else? I am also looking at immuno therapy. I have an appointment to see my oncologist on Tuesday to discuss these two treatments among other things. But I am definitely not having surgery!

[@shorttrackstoriesbyrickcro260]

What is the PSA rise number you would use to mandate restarting Lupron during a treatment holiday?

[@thomaslawson4253]

if a person has maintained

[@DavidMcDanielElectrical]

What is an acceptable PSA level for someone who wants to take a "Holiday". I'm on Lupron right now and my number is 1.4.

[@garymishler770]

What does low and stable mean? what PSA LEVEL IS LOW AND STABLE?

[@PankajKumar-gr5vv]

My dad having prostate cancer stage 2 and he has Harmony Therapy (Orchiectomy+ Bicultamide) So, Could you Please tell me what will be the Survival time(Years) of my Dad?????

[@John-the-Bass]

Thank you , you are very reassuring.

[@dmyhre943]

I am surprised that gu's are not aware of the fact that two non-cancerous causes for higher PSA exist as well...high levels of free testosterone in your blood as well as inflammation causes PSA to rise dramatically.. this fact has been established by studies... I suspect that administering high doses of testosterone creates an environment for high PSA without the suspicion of the tumor growing.

[@drhunasikatti]

Is there increased risk of CAD-AMI with Hormonal Therapy after long time ( > 10 years?)-Thanks

[@kellyclover5953]

I have a bad case of enlarged prostate with calcium deposits in the prostate as well as a distended bladder. So far no proof of prostate cancer, but problems with pain, not just frequent trips to the bathroom.

[@joylambert3118]

Are the shot safe, if there are several tumors will the shots for bones and cancer allow a recovery that's if the tumors have already travel like in prostate stage4

[@tnvol5331]

I had prostate surgery 3 yrs ago. I recently had a PSA test of .17. It was my first PSA test in 2.5 years. I am going to make an appointment with my Urologist very soon. What steps should I take?

[@capresti3537]

What if the hormone therapy stops working. It does not work forever then what happens?.

[@thomasluebke2814]

Will an MRI after radiation treatment show a cure? I am confused that psa is the only avenue for showing cure rates, Your opinion will be appreciated

[@jlane9055]

The best information I have had, THANKS.

[@maebnus46]

How is the research doing in finding a more specific marker to detect just prostate cancer and not other body areas that also show some sensitivity to the test ?

[@foodislifesouthafricacapet3716]

My husband's urologists removed both his testicals on the 20th of June, 2 months before that he went on hormone blockers tablets and one injection... Gleason score 9 and had a PSA of 132 4 months ago ... Back on the 1st AUGUST FOR PSA TEST. This video just gave me hope.... South Africa Cape town. What is a good PSA score that we should be seeing on the 1st August

[@ThePCRI]

Hello, feel free to contact our helpline at pcri.org/helpline. We have a patient advocate who can discuss your husband's case (via email since you are outside of North America). He can give explanations for different concepts and give you ideas to ask your doctor about based on the latest research. We wish you and your husband the best and hope his treatments go well!

[@drhunasikatti]

Excellent Questions and answers. Thank you !

[@andym74]

This video doesn't address prostate cancer cases that never had radiation treatment but went straight to chemo due to stage 4 condition. After chemo, while still undectable PSA, but signs of mets in scans...are ADT vacations still ok to try?

[@ThePCRI]

Hello, I will add this question to our list for future videos, but in the meantime, one of the patient advocates on our helpline may be able to provide you with some information about your situation; you can find our contact information at pcri.org/helpline.

[@georgefitzhugh6455]

Thank you for sharing

[@cathum]

Awesome info on the hormone therapy - very much appreciated; got bone/CT scans (no metastasis), TRUS (nodule & calcification), PSA reads 42 ng/L; oncologist is asking for biopsy, I’m 67. Should I do it, a bit hesitant?

[@ThePCRI]

Shamil, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@taiseeral-khatib2469]

@@ThePCRI hello ,my dad 68 years old diagnosed with stage 4 prostate cancer with sever bone mets ,abdominal ct shows 7×7 tumor on the liver and small adenoma in adrenal gland The surgeon want to remove liver lesion with out biopsy is it a safe procedure to do ? And he started hormone therapy 1 month ago and 5 radiation sessions on the hips And x Geva Is it good treatment plan ? Or we have to add chemo? Thanks a lot We appreciate your efforts a lot ❤

[@vladlungu3033]

👍✌

[@bazlebreeze9938]

I've tried Leupron but found the hot flashes unbearable. Is there some way to mitigate this misery ? Perhaps smaller initial doses ? Thank you !

[@ferrisburgh802]

Don't know how long you've been on Lupron but I've found that the hot flashes decrease in frequency over time and become less frequent.

[@gvet47]

I don't know why I was told I would have hot "flashes". I can be soaking wet for hours a day. Change to dry clothes multiple times and at night my pillow and sheet is soaked. A miserable life. Tried two drugs to reduce this but they do very little.

[@artmaltman]

Best prostate info on youtube! Question: what is this “hormone resistance” you keep mentioning? Does testosterone reduction stop working at some point? And a related question I suppose: when people are treated appropriately starting say at high intermediate, how likely is that person to ultimately die of prostate cancer.

[@johnhazelton7510]

It’s not hormone resistance, we already have depleted our hormones, it’s castration resistance, the cancer responds even though there’s a lack of testosterone