This is odd. On what basis is the urologist wanting to do this shot? I
see
no reason for it, based on the minimal info you provided (PSA=0). I
think
if that was me, I'd give the Onc much higher judgement value.

Yes, I did.

I had had 4 months worth of Lupron injections starting 6 weeks
before my first HDR brachytherapy procedure.  I didn't like the
Lupron and there was some evidence that it was causing liver
problems for me.  The doc suggested I continue for a full year to
get the full benefit of the therapy, but I declined it and she
concurred that it wasn't a bad decision in light of the liver
problems.

My PSA shot up after I got off the Lupron, then bounced up and
down for about two years, then began a steady decline.  The last
reading, 3.5 years after treatment, was .21, which is pretty
good.

Your husband's undetectable PSA is not a reliable reading at the
moment.  It is more likely caused by the Lupron than by the
radiation.  It is very possible that his PSA will rise when the
Lupron wears off, 3-6 months from now.  However, don't be
alarmed by that.  Unless the PSA rises steadily from reading to
reading, and continues to rise for at least three successive
readings, there is not yet evidence of treatment failure.

There are varying theories about how long a man should be on
Lupron when taking it as an adjunct to radiation.  There is some
evidence that 3 years provides the best results, some evidence
that 2 years is enough, some that 1 year is enough, and some that
just 6 months is all that's needed - at least that's my layman's
reading of the literature.  Conservative doctors (or aggressive
ones, depending on how we define "conservative" and "aggressive")
may recommend maximum treatment with long courses of hormone
therapy.  However there are other doctors who don't do that.
To my knowledge, there is no medical consensus on exactly what to
do.

It is possible that, by declining another injection, your husband
has slightly increased his odds of a recurrence.  But it's not
clear that the increase is very great, and there are side effects
of Lupron to be considered too.

In any case, one advantage of getting off Lupron, in addition to
the obvious one of recovering from the side effects, is that you
will get some real indication of the success of the radiation
therapy.  If it turns out that the procedure was successful, and
that further Lupron wasn't needed, you'll both be glad he didn't
take it.  If it turns out that the procedure was not successful
and he needs to get back on Lupron, he'll be able to do that in
the future after considering all alternatives, including watchful
waiting.

Good luck.

   Alan

Some more notes on your posting:

I found it hard to get off Flomax.  I did it gradually.  From
taking two pills a day I reduced it to one pill a day, then
eventually to one every other day.  Each time I reduced the
dosage, I found I still needed it and had to increase it again,
but I kept trying and eventually was okay without it.  It took
me about five months after seeding.

The other note I'd like to make is that waiting one year for
the next PSA test may be longer than desirable now that
your husband is getting off Lupron.  I suggest getting tested
for PSA and for testosterone in six months or so.  This
will give you some information about what the PSA is doing
after the Lupron wears off, and the testosterone reading will
indicate to what extent the Lupron actually has worn off.

If the PSA is above some number, I'm not sure what, then he
might want to get PSA tests every three months to find out
what the trend is.

I don't see any special reason why these tests have to be
ordered by the urologist.  A general practitioner could order
them if that is more convenient for you.

But, I'm not a doctor and your husband's doctors, who know
more than I do, may not agree.

   Alan

My story may be of interest to you. I am currently 54. Was diagnosed
with PC 2 years ago and had an RP the following January. PSA at the
time was 4.3. After the surgury my Gleason score was rated at 4+4=8
with negative lymph nodes. 3 months after removing my prostate is when
the first blood test is taken. It was <0.1.  This qualified me for a
clinical trial that proscribed 50 mg of Casodex daily and Zolodex
shots every three months for 2 years to see if this hormonal treatment
BEFORE recurrence of disease was beneficial. Actually what the trial
was comparing was the above treatment vs. the above treatment AND
chemo. After following the treatment for 8 months I stopped taking the
drugs because of severe side effects including weight gain, increased
triglycerides, osteopenia, memory loss, and trigger finger. So far,
knock on wood, my PSAs have continued to be <0.1. Hope this is of some
help to you.

Best of care,

WhiteSoxFan

I did not have brachy.  Just wanted to reinforce that I think it's a
decision that has to be made balancing the known effects of ADT and the
small increase in percentage of his eventual cure.  And, it is certainly
your (you and he) decision to make; not his doc.

I only emphasize that the decision criteria are as mentioned and the PSA of
0.0.  Having an oncologist say, "everything turned out well" is not.  He
could mean a lot of things, the least of all being that your hubby is cured.

I think it's a sound decision and time to get on with the rest of your
lives.