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Blood draw results and Lupron -- should I continue?

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Posted 5/5/2019 6:13 PM (GMT 0)
I completed 39 treatments of SRT recently and my six-month run of Lupron ends in a couple of weeks. My PSA is now at <0.01 and my testosterone is at 16.

I saw my RO last week for a follow up visit and she said she would defer to my urologist as to whether or not I should continue Lupron. This came as a surprise to me as I was under the impression from them and Sloan Kettering that 6 months would suffice. Side effects from Lupron have been almost non-existent for me; however, a blood panel ordered by my cardiologist last week showed some distressing results. A number of the tests came back "out of range" including WBC, RBC, hemoglobin, lymphocytes, carbon dioxide, cholesterol, and triglycerides.

As I have a mild case of coronary artery disease (no stents, just a build-up of calcium), I am concerned that any additional Lupron will have adverse affects on my overall health -- especially on my heart. I am going for a stress test on Thursday and will discuss all of this with my cardiologist. I see my urologist in a couple of weeks to discuss Lupron. Any thoughts about my concerns would be appreciated. Thanks.
Posted 5/5/2019 6:57 PM (GMT 0)
Your urologist's job is done. At this point a Medical Oncologist should leading the team.. In order to continue the Lupron, you need to sit down with an MO and do a risk / benefit analysis. You might be better off stopping the ADT or you might not.. You are a high-risk case so aggressive treatment is warranted..Your RT is probably responsible for most of the blood work anomalies..Your blood counts should slowly recover..
Posted 5/5/2019 6:58 PM (GMT 0)
if i'm reading your signature correctly you are a G9, surgery failed immediately and SRT commenced somewhere beyond .32?

if that's the case six months of ADT puzzles me. seems like it should have been longer if they think there's still a shot at a cure. but i'm no doctor. as far as the negatives effects of treatment I read this yesterday by the quotable Fairwind:

"..If the cancer doesn't kill you the drugs and treatments they give you will..Pick your poison...We all end up in the same place.."
Posted 5/5/2019 11:18 PM (GMT 0)
Motown why would your RO want to give you back to the urologist their job is done? You need to stick with the RO or move over to a MO. I myself would probably wait 3 months to see if your still undetectable and then take it from there with your heart condition but I"m no doctor, so your team which might involve your heart doctor and yourself will have to look at all the options and then make a plan. I have a very good friend I was down at the Mayo with last week that has to have a heart valve replacement mainly due to large buildup of calcium attributed to 10+ yrs of Lupron so yes it's something to think about that's for sure. Wishing you the best both in PCA and your Heart Issues!

Larry
Posted 5/5/2019 11:34 PM (GMT 0)
Get a strong medical oncologist with advanced PCa experience. Your urologist and radiation oncologist are done. High risk dx, very young age and a late SRT tells me a longer period of ADT should be considered.
Posted 5/6/2019 2:21 AM (GMT 0)
Motown,
I agree with the others, find a good medical oncologist and discuss whether you need to continue the Lupron or not. Your RO and urologist are done with you.
Posted 5/6/2019 1:14 PM (GMT 0)
I agree that the Radiation oncologist has completed his/her run. As to the period of Lupron, that can be decided by the patient in consultation with his specialist, whomever that may be. It is most likely to be a medical oncologist. The urologist was the referring physician, I assume, to the RO. If you have no urologic issues then he has finished his job.
To the larger question, there are certainly issues here that are not presented in this forum about your situation which is too brief to provide a complete plan, and I am unwise to make recommendations about your treatment.
Consult your medical oncologist about your continuing care.
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