On a Lupron Rollacoaster

Redf,

Sorry to see you back with us. Looked like you had escaped.

For the benefit of other guys who may be able to give you advice, here is a brief recap of your postings on this forum to date. I see that you had your prostate removed in the summer of 2008 with a post-op pathology of Gleason 6 with focal positive margins. You had salvage radiation in the fall of 2009 and now you find yourself on intermittent Lupron trying to control your PSA.

Have you had any scans to try to explain the rising PSA? It is getting up into the range where one would expect things to start showing up on scans.

It sounds like maybe Gleason 6 isn't as harmless as a lot of people believe...Have you had your testosterone level checked? Sometime the hormone drugs don't work as well as hoped..I would ask about adding Casodex to the drugs you are taking..Seeking a second opinion as to your treatment plan would be a good idea...

Fairwind said...
It sounds like maybe Gleason 6 isn't as harmless as a lot of people believe...Have you had your testosterone level checked? Sometime the hormone drugs don't work as well as hoped..I would ask about adding Casodex to the drugs you are taking..Seeking a second opinion as to your treatment plan would be a good idea...

Farirwind beat me to the punch, so I will just cut and paste what we discussed last night on the Inspire.com site so our brothers here can add, cange or delete.

Firstly, it sounds like your onco may only be measuring PSA and not Testosterone.

T does not cause PCa but once you have PCa, it feeds off the T. Depending on who you listen to the Lupron needs to get your T<50 or T<20. The PSA is an indicator but tells the onco nothing about your specific T count.

Depending on your Gleason score, (I am assuming at least one if not both of the 2 numbers that get added together is >=4) your goal for being on Lupron til you reach a certain level may vary, but onco has no idea wheter your T is <50, = 50 or >50, and ditto for 20. You need to jointly agree to give Lupron a chance to finish its mission with respect not only to PSA but also to T before yoyoing on and off of it every few months.

Gleason score is much more of a trump card than PSA with the latter making its most sense in combination with yout T level.

If your onco does not specialize in PCa cancer and does not measure T, time to at least get a second opinion from a Medical Oncologist who does, and depending on what that second opinion is, decide whether to continue to retain your current oncologist.

Secondly each PSA can ber elevated for a number of reasons, infection, whether you had sex within prior 72 hours, bike riding etc. So keep those elements as constant as you can from PSA teow st to next PSA test,obviously cannot control infection in advance as much as Y/N to sex or bike riding, endorectal MRI's or any massaging in neighborhood of the prostate, etc.

Not a medical professional, just my opinion but we all know that free advice is at least worth its price, sometimes not much more.

edit - as it turns out one of my assuptions was wrong sicne PeterDA indicated you were a Gleason 6. So his advice to try and isolate the tumors causing the PSA wit a scan has a lot of merit. Personally I prefer the F18 over the standard whole body bone scan. You can also ceck out Dr Kwon at Mayo clinic in rochester whose C11-Choline is typically covered by insurance, if you want to go straight tothe advanced scan rather than standard MRI's or CT scans.

LupronJim.