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Update on my SRT and Lupron / When will I know of cure?

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Posted 2/10/2019 4:55 PM (GMT 0)
I thought I'd share good news regarding my SRT and Lupron. 3 months in on the Lupron and no side effects, except gaining much-needed weight, as I lost 37 pounds after DX in March last year, 14 of 40 SRT treatments completed. PSA dropped from .34 to .07 in first month of Lupron. Next 3-month shot this Wednesday. Some GI issues from SRT, no fatigue yet.

Question that I plan to ask my Urologist on Wednesday but thought I'd post here: If my SRT finishes on March 15 and my next 3-month Lupron shot is this week, when might I know that the treatments were a success (or failure?).

Wishing all of you well,

Paul
Posted 2/10/2019 5:59 PM (GMT 0)
Glad you are doing well. Weight loss is very tough on ADT, great control.

It can take a very long time to determine success. The basic first determination is a very low, hopefully undetectable PSA after the testosterone returns to normal levels after ADT is stopped. Radiation can take several years before all the PCa cells that were radiated finally die. While they may still live for quite awhile, once they are radiated they will no longer divide, grow and spread.

Prostate cancer is like the cells it is derived from, long living. The prostate cells are some. Of the longest living cells in the body and that trait gets passed along. Thankfully, most PCa is not fast growing or aggressive like so many other cancers.

You have just starting SRT and ADT. Thus you have to wait for the treatments to have effect. It will be awhile, so don’t get in any hurry. I am eight years out and thankfully my PSA has been undetectable, but that doesn’t yet mean I am cured. I am in a long and durable remission, but recurrance after 7,10 even 15 years do occur. This is not to scare you, just to remind you of the way this disease can behave.
Posted 2/10/2019 8:55 PM (GMT 0)
One of the key milestones is 6 months after the Lupron has run its course. So you have a while to wait. And don't know if those of us who had persistent PSA after surgery can claim "cure". Hopefully so of course but I prefer to just tell people that everything looks good and PSA is undetectable.
Posted 2/10/2019 10:30 PM (GMT 0)
You're on the slow road. Once you finish your ADT, you'll be able to start figuring out success/failure, so it could be a year or more.

But for now, no progress, PSA down.

Something's working!

Focus on that.
Andrew
Posted 2/11/2019 4:17 PM (GMT 0)
You're just starting SRT and are still on Lupron. These treatments should quickly reduce your PSA but you will need to wait for the effects of those treatments wear off before you get meaningful clues to their effect. Even after you've finished with Lupron it's effects will persist in your system for many months after your last shot. It will take longer than 3 months for the effects of a 3-month shot to be gone. Also the effects of radiation on your PSA can be erratic for a while and can take a year or more before your PSA hits a true nadir.

As for knowing when/if you are cured, I think it's best to instead think in terms or probabilities rather than cured / not cured. Because that's the way pretty much all science and medicine works - based on what you know so far a chance of recurrence is a percentage not a definite yes or no. The good news is over time the percentage can become so low (the chance you'll be hired as the next Red Sox closing pitcher) that you can pretty much stop worrying about recurrence. And if it goes the other way (the likelihood you'll have to pay taxes) you can also stop worrying about it and get on with a new course of treatment. But in the meantime there is just the unpleasant truth that you have to get used to living with a measure of uncertainty that over time and with luck will approach certainty, even if it never completely gets there.

Personally, I'm pretty comfortable with the knowledge that cancer might kill me sooner or later. But I'd rather not worry about cancer when I might instead end up being hit by a falling piano. I'd hate to have to think in my last moment squashed on the sidewalk, "Darn, I worried about the wrong thing all these years."

Best of luck with your treatment.

Jim
Posted 2/11/2019 4:29 PM (GMT 0)

Bohemond said...
As for knowing when/if you are cured, I think it's best to instead think in terms or probabilities rather than cured / not cured. Because that's the way pretty much all science and medicine works - based on what you know so far a chance of recurrence is a percentage not a definite yes or no. The good news is over time the percentage can become so low (the chance you'll be hired as the next Red Sox closing pitcher) that you can pretty much stop worrying about recurrence. And if it goes the other way (the likelihood you'll have to pay taxes) you can also stop worrying about it and get on with a new course of treatment. But in the meantime there is just the unpleasant truth that you have to get used to living with a measure of uncertainty that over time and with luck will approach certainty, even if it never completely gets there.

Personally, I'm pretty comfortable with the knowledge that cancer might kill me sooner or later. But I'd rather not worry about cancer when I might instead end up being hit by a falling piano. I'd hate to have to think in my last moment squashed on the sidewalk, "Darn, I worried about the wrong thing all these years."

Best of luck with your treatment.

Jim

Thanks Jim.

It's both reassuring and affirming when things like this are posted. Matter of fact, it does more than that. It turns my day into something to be enthusiastic about.




Motown....thanks for asking the question. I've wondered about this myself, but wasn't really sure how to ask it. (For loved ones, whom will never know why I want to know. For my benefit only. thanks man)
Posted 2/11/2019 5:18 PM (GMT 0)
Hi Paul,

Glad to hear of your PSA drop. My husband started a 3 month Lupron treatment 6 years ago and his PSA also dropped substanitually. FYI my husband didn't get side effects until about the 3 shot.
His side effects were weakness in his hands, tired, weight gain, depression.
Everyone is different however.

We were told that the fact that the PSA dropped after the first shot, that this is a good sign for longevity of this horrible monsterous disease.
He is going on 8 years with a lower PSA although not undetectable 1.6 still low with mets.

He now gets MO Lupron injections with basically no side effects.

He is now on a monthly. Lupron injection which has proved to be easier regarding side effects for him.

Keep up the fight.

BOOGEE
Posted 2/11/2019 7:02 PM (GMT 0)

BOOGEE said...

...We were told that the fact that the PSA dropped after the first shot, that this is a good sign for longevity of this horrible monsterous disease.
He is going on 8 years with a lower PSA although not undetectable 1.6 still low with mets.
....Keep up the fight.
BOOGEE

How true; don't stop fighting!

It is a maddening disease, both a blessing and curse that we live sooooo long knowing we have it. Better than most cancers that make one miserable, then kill in short order.

To paraphrase the quote, I'm trying to, "get busy living, not get busy dying". Stay positive!
Posted 2/11/2019 11:14 PM (GMT 0)
Paul,
If I were you I'd monitor testosterone, as well as PSA.

Bobby Mac
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