When to go back on HT after Vacation.

Hi All,

My husband has had a year off from his 1st Ht therapy. which was 8 months. Of course his T level is starting to rise and along with it the PSA.
Such a double edged sword !

He is still at a 0.2., but it doubled in 3 mos. DR says don't worry yet to be expected. i knew that.
I was wondering at what PSA he will start again.
I will Email the DR tonight about the Metformin, he was a bit negative about the Avodart when I asked before. He does'nt like the moobs side effect . He is a renown Onc in PC at Smilow.

Thanks

I thought it was already there
here it is

Hi LSil,

I am in my third round of intermittent HT, just had my last 4 month shot of the expected one year "on" phase. My onc and I seem to have settled on a PSA limit of 10 for starting/restarting HT. The onc thought we could safely wait til 20 if there was no evidence of mets but with a doubling time of less than 3 months we both got antsy when my 3 month PSA tests hit 9 or 10 and restarted shortly thereafter. Repeated CT and bone scans at those PSA levels have shown no evidence of mets. My initial year of HT also began at PSA=9.6 and it took over 2 years to get there after SRT failure.

I am somewhat surprised that your husband's HT duration was only 8 months. I thought 1 year was the common intermittent duration. It takes me about 8 months just to get to 0.1 PSA although in my case the T and PSA suppression continue for 8 months after the last shot supposedly wears off.

As others have said, every case and every doc differs. This is just my experience.

All the best,

Hi Mel,

My second vacation was slightly shorter than the first but I'm a little fuzzy on duration for two reasons: Sloppy record keeping means I would have to dig through old appointment calendars for exact dates and secondly, the HT hangover of ongoing castrate level T makes it difficult to determine, in practical terms, when the holiday begins.

However, my first HT vacation was about a year and a half from the end of the last Zoladex shot to the resumption of HT (Eligard) at PSA=10. The second vacation was a few months less, as you suspect. The first time it took 8 months for my T to recover to the low end of normal accompanied by an uptick in PSA. The second time the doc did not even measure T but I noticed the return of some energy, muscle and libido along with a rising PSA in a similar timeframe.

Vacation #3 begins (hopefully) in March 2016. Can't wait!

All the best,

Dr. Lam has not mentioned Provenge yet.

Mel

Allen,

I realize Provenge is probably better when done earlier...how about these other newer therapies like xtandi, Zytiga, and Xofigo (when bone mets are apparent)? Should they be substituted for the first gen HT if possible or not enough data?

Xtandi, although possibly hard to get, could be used in place of Casodex and the moobs issue would go away I believe.

Jerry

Timely question for us. Nick has been on HT holiday (18 months on, last shot last April). But his blood test today revealed PSA rise from undetectable to 4 in last three months. Sigh. Doc wants to do another blood test in one month but sure looks like it is back to Lupron and Casodex soon.