Completed my first month of ADT therapy, tell me about you PSA reduction after one month

I went from 59 to undetectable in just over three months. Your reduction is expected and should get to undetectable shortly. What ADT are you using? Different agents (Lupron/Eligard/Firmagon etc.) can have somewhat different timelines. Expect the PSA to become undetectable and stay there as long as you are on it. The real test comes about after a year after your last shot. By then the ADT is no longer in your system so not effective. That is when it is most important to see a very low and stable PSA.

Some radiation men become undetectable and stay that way as I have. However, it is common that radiation men have long term low PSA as they still have some prostatic tissue and it may continue to express very small amounts of PSA.

Only time will tell for you so be patient, be confident that your treatment is working as expected and go have fun!!

Hello Mentor5959,

That's a great question to ask --- and our members here can all relate to feelings of anxiety when waiting for PSA results --- in fact, our members here call it PSA ANXIETY --- and yes, it's a true phenomenon for many.

In my case, my PSA is assessed every month, to stay proactive in my treatments. My health history is shown below my signature, at the end of this post. My doctors have been a GODSEND to me, and truly involve me in decisions and discussions.

In my case, my initial PSA was over 100 at diagnosis. I was in my 40s, when I was first diagnosed. Upon confirmation of the diagnosis, I was started on LUPRON shots immediately, along with some CASODEX tablets.

Then began the wondering, the waiting, and yes … the worrying. You might think of them as the three "W" words in terms of PSA anxiety … wondering, waiting, worrying.

I remember my doctor walking into the exam room, one month after diagnosis and my first ADT shot.

He said, "We finally have some good news for you."

After just one month of ADT shots, my PSA plummeted from three digits to one digit. It gave me such hope and encouragement. I can still remember the relief I felt in that very moment.

One month after that, then my PSA dropped down into the decimal levels. In my mind, that perhaps didn't even seem POSSIBLE based on where my numbers were upon diagnosis.

While discussing my new regimen of receiving ADT shots, my doctor said these hopeful words to me, "I'm very encouraged. You are having a tremendous response to ADT."

Since then, chemotherapy and radiation and medications have worked together to keep my PSA in the lower decimal range. I know I have a lot to be thankful for, nearly six years later.

Here's a description that one of my doctors shared, as time went by, in terms of what the ADT shots can do … I still think of these words, even today.

ADT shots essentially remove testosterone, which is the "FUEL FOR THE FIRE" --- and those hormone dependent cancer cells are then deprived of their essential "fuel" --- ADT then begins to "starve and strangle" those hormone dependent cancer cells.

I liked the description of cancer cells being "STARVED and STRANGLED" --- and I have been on continuous ADT shots for nearly six years now, based on my particular case. On a day when you don't really want to get a shot, just remember that phrase, and what those ADT shots are doing … they are going to work "STARVING AND STRANGLING" cancer cells … that's a powerful description, isn't it?

I will never forget hearing my doctor show me a PSA that dropped down into the DECIMAL range, after being diagnosed at a PSA level over 100, initially. That first ADT shot's results gave me tremendous hope.

Handshake, from across the miles,
CYCLONE ~ Iowa State University

Fairwind said...
Have you had any other treatments other than ADT? What was your Gleason score at diagnosis ? Bone and PET scan results ?

Every case is different. ADT does not work the same on all patients. Some much better than others..

This info is all in my signature but for some reason my signature is not showing!?????

No bone scan taken, the PET showed it was confined to prostate Gleason, 4 plus 3. (7)
.

I was on Degarelix (Firmagon), which has a faster initial reaction than Lupron or Eligard. My PSA dropped from 6.62 to 0.45 in one month, 0.08 in two months, 0.03 in three months, undetectable <0.02 by month 5.

mentor5959 said...

Bohemond said...
I was on Degarelix (Firmagon), which has a faster initial reaction than Lupron or Eligard. My PSA dropped from 6.62 to 0.45 in one month, 0.08 in two months, 0.03 in three months, undetectable <0.02 by month 5.

So then my PSA reduction after one month of Degarelix from 9.3 to 2.4 was not nearly as effective. ;-(

NOOO, you missed the important point in several posts that everyone's reduction curve is different and can't be compared. Relax you are doing fine at the beginning of treatment.

Mentor, there are two key measurements concerning ADT.

First, it stops the gonadal production of testosterone and is measured by having castrate levels of T. Most docs like to see T under 30, which you have reached. You won’t get to 0 because there is still DHT being produced, but at greatly reduced levels.

Second, the PCa growth is retarded by the T reduction and expresses less and less PSA so long as the PCa is hormone sensitive. You are showing this reduction which is according to plan.

There is no one standard as everyone is different. Different G scores, different dx PSA levels, different amounts of PCa, the DNA is different, etc. We have seen in the dozen or so posts that some reductions were faster than you so far and some were slower. Doesn’t mean a thing.

The key is your T is at castrate level and the cancer expression of PSA has reduced. Both are the initial signs that are desired. So far, so good. Let’s all hope the trend continues.