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Testosterone of 34 on lupron?

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Posted 7/21/2017 1:00 AM (GMT 0)
Doesn't that seem kind of high? It was 17 at lowest. Wondering if that's why psa is rising.

Which btw his psa is .29 today stable as last month was .30.....

Just that testosterone seems like it should be lower....
Posted 7/21/2017 1:28 AM (GMT 0)
50 is considered castrate. 30 is a typical goal - 20 if you're lucky. Adrenals produce some T. If it gets high enough that it affects his PSA, he can try switching to Firmagon, another GnRH agonist, estrogen patches, or ketoconazole. If his PSA keeps rising in spite of those, Zytiga+prednisone or Xtandi would be next.
Posted 7/21/2017 1:46 AM (GMT 0)
He picked up zytiga today but I'm wondering now if he skipped a step and should try another that you mentioned first....

It was under 20 for so long. ..
Posted 7/21/2017 2:16 AM (GMT 0)
No - Zytiga is great stuff! I only mentioned the others if his PSA rise didn't yet qualify him for it thru his insurance.
Posted 7/21/2017 3:29 AM (GMT 0)
After the introduction of Lupron you seldom hear the word Orchiectomy mentioned in the States anymore..But it's still the most effective means of lowering testosterone. Since he will be on Lupron or Eligard or Firmagon the rest of his life, you might investigate this alternative to the drugs..
Posted 7/21/2017 10:54 AM (GMT 0)
Paul won't agree to any surgery at all unless it's an emergency. Even then I'm not sure he would. He still has nightmares since his previous surgeries where he had awareness.
Posted 7/21/2017 11:47 AM (GMT 0)
Intraoperative recall can certainly have severe and long lasting emotional repercussions which can be considered PTSD. In response to your original post, my RO says anything below 50 is considered effective. Mine is 30 at six months on Lupron, and I only have one testicle.
Posted 7/21/2017 12:33 PM (GMT 0)
I am in a similar situation. I began Firmagon in June2016.

Initially, the PSA and T went down, however, by February of this year the PSA was on the rise, but the T was 14.

We added Xtandi that month (2/17) and the PSA immediately improved and reached <.01 within 3 months. However, the T began rising and is now .61.

I am in the middle of Provenge treatments. We're going to complete that then take a look at the options Tall Allen discussed above.

6 years ago I would have been all worked up about this, but, I've come to realize that this battle will require many tweaks to keep this disease at bay.

Do your research, listen to the good advice you receive on this forum, and above all, don't give up.

Tony
Posted 7/21/2017 8:12 PM (GMT 0)

Dear Kukukajoo,

I always follow your posts and I'm thankful for your loyal contributions to the website ...

My oncologist was concerned when he noticed my testosterone levels showed "spikes and flares" --- and then my PSA would rise and fall, along with it.

So --- he said, "Are you willing to trust me and try something else besides LUPRON? I feel I can get better control of your testosterone levels, perhaps, by trying another form of ADT shot."

I had been on LUPRON for quite a few months ... we next tried FIRMAGON shots ... but that didn't seem to achieve the lower testosterone level we were hoping to see.

We then tried ZOLADEX injections ... the testosterone stabilized and went lower.

I was thankful my oncologist had the foresight and willingness to try the other forms of A.D.T. shots --- he stated, "If nothing else, we can always return to LUPRON at any time."

In my case at least, switching to something else seemed to give us better testosterone control, which led to greater P.S.A. suppression ...

I know you are just starting ZYTIGA ... that, along with the ZOLADEX A.D.T. injection has kept my testosterone level below 10 now ... which has been helping to keep my P.S.A. in the lower decimals.

I just ordered my 25th monthly bottle of ZYTIGA this week ... I started keeping the empty bottles, all lined up on a shelf, just to keep track of my progress on ZYTIGA.

ZYTIGA has helped me a great deal ... knocking my P.S.A. down to the lowest level I had ever seen since I was diagnosed.

May it work wonders in your case!
I.S.U. "Cyclone"
Posted 7/22/2017 1:43 AM (GMT 0)
Thank you Cyclone. I am looking into everything I can find. His FACBC scan was approved with no issues and scheduled Aug 15th.

I will ask about the other meds as everything is worth a try.

I just found out there are genetic variances that may affect Zytiga.... and possibly other meds as well. Looking into this now.
Posted 7/22/2017 1:45 AM (GMT 0)
https://www.ncbi.nlm.nih.gov/pubmed/27409606?dopt=Abstract

Int J Mol Sci. 2016 Jul 9;17(7). pii: E1097. doi: 10.3390/ijms17071097.
Common Genetic Variation in CYP17A1 and Response to Abiraterone Acetate in Patients with Metastatic Castration-Resistant Prostate Cancer.
Posted 7/22/2017 6:01 PM (GMT 0)
Kukukajoo,
I am keeping those thoughts and prayers hoping your way that Paul has the same success as Gary on zytiga, but with more durability. It sure has worked well for Todd, CYCLONE, and many others. How is Paul feeling as of late? Are you doing ok?
Hugs to you both.
Beth
Posted 7/22/2017 11:01 PM (GMT 0)
Apparently he's got a genetic variation that men who have it are more likely to progress faster on zytiga with much shorter duration to failure. Of course after Paul just picked up his first months supply.... xtandi isn't affected by this variation so may need to start that.

I'm tired. Wore out. Paul is too but today more energy than me.

Always thinking of you my friend.
Posted 7/26/2017 12:59 AM (GMT 0)
Oncologist said just start zytiga and take whatever it adds to length of life. If it doesn't work or stops working then he'll switch to xtandi then.

No other news to report.
Posted 7/26/2017 3:58 AM (GMT 0)

Hello Kukukajoo!

Praying for good results on ZYTIGA!

Please let us know how things are going, once you get started!

Thinking of you both,
"Cyclone" From I.S.U.
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