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What options after surgery and radiation?

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Prostate Cancer
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Posted 9/2/2012 11:55 AM (GMT 0)
Four years ago, surgery, last November December seven weeks radiation, now PSA starting to rise currently at .49. Next PSA scheduled at Mayo ( all treatments there ) in November? Is hormone therapy or oral drugs next? Should I ask for an earlier appointment as PSA is not going down.
Posted 9/2/2012 12:40 PM (GMT 0)
The standard protocol is to start ADT (hormone therapy) as it appears obvious that there is cancer outside the area that was removed and radiated. If it were me, I would be getting an earlier appointment. The more your PSA rises the tougher it will be for the therapy to be effective.
Posted 9/2/2012 6:35 PM (GMT 0)
Thank you for responding to my inquiry. I will request an earlier appointment. Thanks again.
Posted 9/3/2012 12:03 AM (GMT 0)
Sooner the better...

NewspaperLover
Posted 9/3/2012 1:54 AM (GMT 0)
I am feeling a sense of urgency. My appointment was for November, I will now strive to get it as early as this month? It was suggested I get a Lupron shot at the beginning of my radiation treatment; however, decided to allow these two treatments to stand on their own merits. I believe Lupron maybe the next step in Hormone treatment. Are there other choices ,or is this the leading prescribed HT drug? Appreciate any and all comments?
Posted 9/3/2012 5:26 AM (GMT 0)
Take your time and follow your doctors recommendations and options with optimism. If you are not certain or comfortable with the recommendations then get a second opinion from other institutions.

An important note ~ you don't state is what the PSADT or ~ PSA Doubling Time is. A series of a few PSA tests will tell you that. One thing you should not think ~ that you need to rush everything. I have also heard that earlier the better for ADT but I have also heard that PSA's below 2 ~ below 4 are still treatable and effectively with ADT. I believe that it is important to know how the disease is behaving before masking that opportunity with ADT. Talk to your doctors and see what they think. There are a lot of good options available including clinical trials to consider.

There are some great ADT trials going on, and while I cannot say what I see, there is more coming.

.48 is very manageable. Stay positive and hopeful. That's very important. Mayo has some world-class doctors and are leading researchers.

There is good reason to stay positive right there...

Tony
Posted 9/3/2012 8:50 PM (GMT 0)
Hi Luigi,
I reviewed yesterday the 11 years of PC care my father had up to now.
Two years after surgery PSA start raising again : this lead in order to immediately start hormone therapy ( casodex plus lupron) and RT few months later. This was happening in march 2003 (rise of psa and start of hormone therapy) and november same year (RT): the Uro managed to control PSA for ~8 years with this therapy... The two drugs were suspended and restarted again several time keeping psa between 0.x and 3.x.
I agree and undertand your feeling of urgency - I would feel the same - on the other side what I saw in these years is that with these kind of therapy it's not matter of days... As Tony is saying getting info about PSA doubling time could be interesting

L.
Posted 9/3/2012 9:13 PM (GMT 0)
In response to doubling time, last year, 2011 February PSA .2--- then in 09/11 .375. RT November December (surgery three and half years ago- 05/08). In May 2012 PSA still at .375. Then this Augurst PSA .478. The Urologist stated "we know it is not in the Prostate area, perhaps in the lymph nodes, let's watch it for six months" that comment was made in the May 05/12 check up. I understand there is a published doubling scale doctors consult, not sure how to find it as a patient. I know I am a candidate for some type of additional treatment as the PSA is not going down. I just want to have some choices in the matter. I really appreciate and thank you for your interest and personal response to my inquiries.
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