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Posted 1/27/2013 6:42 AM (GMT 0)

Will Provenge only improve immune system or also reduce PSA? How does not Provenge help. If after Provenge PSA continues to rise can I get Feraheme MRI/C11 Pet scans done to check for metastases?

Oncologist suggesting Provenge if PSA  continues to rise  from 0.07  post RP and adjuvant EBRT+ Hormonal. It  has just started to increase from undetectable to 0.04 to 0.07. Have  more PSA and other tests scheduled next week and then 3 weeks later.

Post RP this year in April my PSA was undetectable (< 0.03). However started with hormonal (Zoladex) in May and then Radiation(Prostate Fossa( in September-completed Nov 7th. Post radiation PSA test done 4 days later was 0.04 and  7 weeks later was 0.07.

Thanks

berco

Age-58 years-PSA January 16th, 2013-0.07

PSA November 15th,2012-0.04

Adjuvant Radiation -Prostate Fossa completed-November 7th RP-April 2012 Post RP PSA was undetectable <0.03  till Sept 24ththe  day I started radiation. Started with Zoladex ( Hormonal) on May 15th and  added Casodex today on January 16,2013.

Surgery Pathology- Gleason -5+4, both SV invaded, 1/17 Lymph node cancerous,

1 Positive Margin, Extra prostatic extension/ Lymph vascular invasion/Perineural Invasion-Extensive, TNM staging-pT3b-N1-MX

Posted 1/27/2013 11:17 AM (GMT 0)
Living1963- has been there and done this and can answer alot of your questions on this, he recently was with Dendreon in Florida for a like conference event thing. Apparently psa is not used as a guide of how effective it is, which is very strange to us HT patients understanding, you can use CTC (circulating tumor cells tests) to perhaps get an idea of what might be going on. You have many options in first and second line HT therapies you could consider doing and you have to find out if insurance will cover the $93,000 Provenge treatment(s). Have you looked at www.hrpca.org    to see what various drugs have been used by many over the years? Yes, some of these scans seem to be more definitive than others, so you would have to look into that closely if considering which one(s) to do. There are some clinical trials that are looking pretty interesting too. Best to your looking at all options.
Posted 1/27/2013 3:00 PM (GMT 0)
I have read that after radiation the PSA can rise and then fall later. PSA may not immediately gauge the cancer after radiation therapy. So there sometimes is an element of educated guessing regarding recurrence after radiation,if you are not on hormone therapy. Are you still on hormone therapy? That would make a big difference in deciding on treatment.
Provenge does not always lower PSA even if it enhances immunity against prostate cancer.
Good luck.
Posted 1/27/2013 5:54 PM (GMT 0)
It's a cost-benefit issue...
Posted 1/27/2013 7:46 PM (GMT 0)
I am still on Hormonal-Zoladex(started 1 month after surgery) and Casodex (started 10 days back) after PSA reading of 0.07. On a vegan diet
Posted 1/28/2013 12:19 AM (GMT 0)
Provenge was gauged at how early metastasis is discovered this was why husband was given this treatment. Bone mets (spots) in September 2011, Provenge started (three cycles) one in December and the remaining 2 cycles completed in January 2012. The cost to our insurance company was in the neighborhood of $216,468.00. It was not beneficial for husband, because in July of 2012 had "full blown" bone metastasis to several areas of his skeleton.

But it can be beneficial to some patients or it wouldn't have been approved by the FDA. Good Luck and God Speed....
Posted 1/28/2013 6:19 AM (GMT 0)
Tednsal

Sorry to hear that Provenge did not work for your husband. These are difficulties that all of us face.Keep trying to find the treatment that works for each of us, not ebing sure that the treatment that worked for others will work for you or me.

Thanks for the good luck and same to you and your husband.
Posted 1/28/2013 6:50 PM (GMT 0)
Berco,
I am sorry for the late reply. I have been so busy as of late that I don't get online much anymore.
I became refractory a year and a half ago and I opted to do Provenge.It was no easy task getting my h.m.o. (Kaiser Permanente) to treat me with Provenge but finally after 4 months of appeals the State of Washington saw it my way and kp was overruled. I completed my last infusion of Provenge on June 1st 2012
I realized at the time of my treatment that psa was noy a factor in provenge effectiveness. My psa prior to provenge was about 100. Aftrr my provenge treatments my doctor put me back on casodex to lower my psa. It should have been a short term benefit as I had already failed casodex. 8 months out from my lasy provenge infusion and my psa is under 5. I feel good and i am very active. I have no idea if this helps but it is what it is. I believe in provenge. I believe the sooner it is used the better. This is just my opinion but it is an opinion based on experience.
Posted 1/28/2013 7:29 PM (GMT 0)
Living 1963
Thanks very much for sharing your experience. Waiting for the next 2 PSA results next month before my oncologist decides and of course then insurance (Blue Cross, CA) approval.

You were on Lupron/Casodex.Was Proscar/Avodart added any time? Some oncologists add and refer to it as ADT3. My oncologist does not and hence asking?

Will update all if I go in for it and my experience
Berco
Posted 1/28/2013 7:54 PM (GMT 0)
Berco. Nope just lupron and cassodex. I did a short stint on D.E.S. I was not impressed. I had to havemy.chest radiated as I was growing breasts. Good luck. Todd
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