I think this is somewhat in flux now.  Different studies have produced
different results.  Also, it can depend on the specifics of the
particular case.  If you trust your oncologist,  you really have no
choice but to go along with what he/she says.   But perhaps you should
ask for a detailed explanation of why he/she came to that conclusion.
If you aren't satisfied with the answer,  you should consult another
independent oncologist.

I was originally scheduled for at least 2 yrs of HT based on my high Gleason
score of 4+4=8. 2years seems to be a standard, but more attention is being
given to intermittant HT,  because of the side effects. I had extreme
fatigue and joint pain during the 1st year so my URO and I decided to stop
the HT and monitor my PSA and Testosterone for a while. There doesn't seem
to be much data compiled on this method of treatment yet, but my URO has
been treating PCa for over 25 years and he has alot of confidence in this
approach. I'll post results as they come available.
More information is becoming available on the side effects of long term HT

On February 14, Stavros Moschos wrote, in pertinent part:

It appears that Stavros is on "neoadjuvant ADT" intended, probably, to
reduce the size of his prostate, making it more susceptible to the
effects of the radiation.

Use of ADT after the course of RT is concluded is often used where the
tumor is aggressive and may have shed cells into the bloodstream. This
is called "adjuvant ADT." That is what I am presently doing, as my
tumors (two of them) were/are Gleason 9 and 8. It can continue for years.

BTW: a nitpick. Many prefer the term "ADT" (Androgen Deprivation
Therapy) as it describes the regimen much more accurately than "HT"
(Hormone Therapy).

Here is a paper on the subject:

Int J Radiat Oncol Biol Phys. 2001 Mar 15;49(4):937-46.

    Updated results of the phase III Radiation Therapy Oncology Group
(RTOG) trial 85-31 evaluating the potential benefit of androgen
suppression following standard radiation therapy for unfavorable
prognosis carcinoma of the prostate.

    Lawton CA, Winter K, Murray K, Machtay M, Mesic JB, Hanks GE,
Coughlin CT, Pilepich MV.

    Medical College of Wisconsin, Radiation Oncology, Milwaukee, WI
53226, USA. colleen@mcw.edu

        PURPOSE: To determine the potential advantage of androgen
ablation following standard external-beam radiation therapy in patients
with locally advanced (clinical or pathologic T3; clinical or pathologic
node positive) carcinoma of the prostate.
        METHODS AND MATERIALS: In 1987 the RTOG initiated a Phase III
trial of long-term adjuvant goserelin in definitively irradiated
patients with carcinoma of the prostate. A total of 977 patients were
accrued to the study of which 945 remain analyzable: 477 on the adjuvant
hormone arm (Arm I); and 468 on the radiation only arm (Arm II) with
hormones initiated at relapse. The initial results were reported in the
Journal of Clinical Oncology in 1997.
        RESULTS: With a median follow up of 5.6 years for all patients
and 6.0 years for living patients local failure at 8 years was 23% for
Arm I and 37% for Arm II (p < 0.0001). Distant metastasis was likewise
favorably impacted with the immediate use of hormonal manipulation with
a distant metastasis rate in Arm I of 27% and 37% in Arm II (p <
0.0001). Disease-free survival (NED survival) and NED survival with PSA
of 1.5 ng/mL (bNED) or less were both statistically significant in favor
of the immediate hormone arm (both p < 0.0001). Cause-specific failure
was not statistically different with a cause-specific failure of 16% for
Arm I and 21% in Arm II (p = 0.23). Overall survival was likewise not
statistically different between two arms, with a 49% overall survival at
8 years in Arm I and 47% in Arm II (p = 0.36). Subset analysis of
centrally reviewed Gleason 8-10 patients who did not undergo
prostatectomy showed that for patients receiving radiation therapy plus
adjuvant hormones there was a statistically significant improvement in
both absolute (p = 0.036) and cause-specific survival (p = 0.019).
                                          CONCLUSIONS: Use of long-term
adjuvant androgen deprivation in addition to definitive radiation
therapy results in a highly significant improvement in regards to local
control, freedom from distant metastasis, and biochemical free survival
in unfavorable prognosis patients with carcinoma of the prostate.

Regards,

Steve J

Hi Stavros,

I don't remember your stats but I was PSA 9, Gleason 7 in 2000 at 39 years.
I did 6 Months of daily Casodex and Monthly Lupron coinciding with 40 3DIMRT
treatments at the end of the hormonal run.  My Dr.  felt that with a Gleason
of 7 or above, that it helped the log term outcome to do hormonal as well.
This just made sure that the testosterone and PSA went to the floor.  You
should ask your Dr. if you are to continue but it may not be necessary if
your PSA number goes to 0.  I was glad to stop hormonal so there was less
chance of becoming hormonal refractory (excuse the spelling) for the future
if necessary.  I am  4 years past, my PSA went up from >0.1 to 0.3 in the
first 1 1/2 years and stayed put until last month.  It went back down to 0.2
on my last test.

Dwight

Well if you're are stupid then so am I. Sure they went through there is no
difference to-date between the cure rate of Op or RT. The choice came down
to RT offered less chance of long term side effects, but with the prostate
remaining you have more chance of cancer returning than if you have the op.
I went for RT assuming like you hormone or as you guys now point out ADT (I
learn something everyday) would cease after RT. Hence it came as quite a
shock to the system when the radiologist informed me I would most likely be
on ADT after RT due to G8 and possible cancer hot spot. She was quite
surprised the oncologist had not informed me. But of course this is the UK
NHS.

Ray