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Posted 6/19/2020 11:00 AM (GMT 0)
Just got my last PSA (21) test and I'm waiting to hear back from my Brachy Oncologist on the next course of action. I'm not looking forward to ADT but I may not have any choice. Are there any other new choices developed since I was here last?
Posted 6/19/2020 12:48 PM (GMT 0)
Depends on how much uncertainty you can tolerate. At this point you might consider going to a Medical Oncologist who probably would order imaging scans to look for mets. If negative, the issue becomes weighing the risks to your current health from the disease vs the risks and SE from ADT. As things stand now. Your recent PSA increase is very small, no where near an exponential doubling time. If PSA continues to climb at a linear as opposed to an exponential rate, and if scans come up empty, you and your MO could discuss monitoring for the time being. Say scans every six months. There is no standard of care at this point — comes down to MO’s judgment and your own feelings towards seeing your PSA increase — albeit at a modest rate. Best wishes.
Posted 6/19/2020 1:20 PM (GMT 0)

NewspaperLover said...
Depends on how much uncertainty you can tolerate. At this point you might consider going to a Medical Oncologist who probably would order imaging scans to look for mets. If negative, the issue becomes weighing the risks to your current health from the disease vs the risks and SE from ADT. As things stand now. Your recent PSA increase is very small, no where near an exponential doubling time. If PSA continues to climb at a linear as opposed to an exponential rate, and if scans come up empty, you and your MO could discuss monitoring for the time being. Say scans every six months. There is no standard of care at this point — comes down to MO’s judgment and your own feelings towards seeing your PSA increase — albeit at a modest rate. Best wishes.

Thanks NewspaperLover,
I was under surveillance at the time when this bloody Covid-19 took over and my 4 month testing got interrupted. My last test was 3.4 so the 21 is a fair jump. Anyway, I'm about start my ADT and will be seeing my new OCO in the next 10 days and getting scheduled for more scans and tests......wish me luck!
Posted 6/19/2020 1:41 PM (GMT 0)
Wow, I thought - probably Newspaperlover too - that 21 was a typo for 2.1. Yes, that's a massive leap. Definitely time for ADT. Ask your MO about adding Zytiga, Xtandi, or Erleada to standard ADT.

Good luck!
Posted 6/19/2020 1:45 PM (GMT 0)
PS, that it such a large leap I'd ask for a retest. Are you sure a decimal point didn't get misplaced?
Posted 6/19/2020 1:54 PM (GMT 0)

mattam said...
PS, that it such a large leap I'd ask for a retest. Are you sure a decimal point didn't get misplaced?


I was thinking/hoping the same and will ask to have it checked for sure....
Posted 6/19/2020 1:55 PM (GMT 0)
PSS, the good news is that ADT will almost certainly bring your PSA to undetectable and hold it there for a long time. Hopefully there was glitch in the test, and you won't need ADT.
Posted 6/19/2020 3:38 PM (GMT 0)
FoxRun...3.4 to 21, yes I'd ask for a re-test. But based on the 3.4 of the previous test, I think you're still looking at taking action.

While I'm very sorry for the reason that is bringing you back here, it is good to hear from you--you were so very helpful to me when I was diagnosed and I've always been grateful for that.
Posted 6/19/2020 6:41 PM (GMT 0)
With a PSA of 3.4, they should be able to spot to location of the met(s) using one of today's sensitive scans. With that knowledge you can look at a more focused treatment, like SBRT.. Just a thought..
Posted 6/19/2020 6:50 PM (GMT 0)

Fairwind said...
With a PSA of 3.4, they should be able to spot to location of the met(s) using one of today's sensitive scans. With that knowledge you can look at a more focused treatment, like SBRT.. Just a thought..

he's saying his PSA jumped to 21!
Posted 6/19/2020 9:37 PM (GMT 0)

Michael_T said...
FoxRun...3.4 to 21, yes I'd ask for a re-test. But based on the 3.4 of the previous test, I think you're still looking at taking action.

While I'm very sorry for the reason that is bringing you back here, it is good to hear from you--you were so very helpful to me when I was diagnosed and I've always been grateful for that.


Hey Michael_T.....it's good to hear from you and thanks for the advice and I hope all is well with you!
Posted 6/20/2020 12:38 PM (GMT 0)
3.4 to 21 in a matter of months? Either a bad test or amazing change in the growth of the PCa. It appears the doubling time from 2013 to 2019 was about two years, but then a seven fold jump in just months? Something is not right and an immediate re-test is in order. Clearly, if it is 21, scans are needed to see where it is for possible radiation. And definitely begin more treatment.
Posted 6/20/2020 5:08 PM (GMT 0)

JNF said...
3.4 to 21 in a matter of months? Either a bad test or amazing change in the growth of the PCa. It appears the doubling time from 2013 to 2019 was about two years, but then a seven fold jump in just months? Something is not right and an immediate re-test is in order. Clearly, if it is 21, scans are needed to see where it is for possible radiation. And definitely begin more treatment.

I agree with JNF. I once, after not changing for about a year, I had a sudden triple in 3 months, which coincided with a change in their machines. Then it proceeded to stay put for another year after that sudden jump. But yours has gone up by a factor of 6 in a short time. Sounds suspicious, something not right. Of course, it could be a real jump and must be checked out, but a retest is in order.

Post Edited (BillyBob@388) : 6/20/2020 2:22:53 PM (GMT-6)

Posted 6/20/2020 8:10 PM (GMT 0)
of course its a misplaced decimal...off with all their heads...my question is why you have not updated the signature to reflect even the 21...dang...things folks do...does anyone think around here...consider that a vent...well deserved...did you honestly think that a jump to 21was a casual jump...yikes...yikes...yikes and yikes and YIKES....oh...have a nice day
Posted 7/14/2020 12:14 PM (GMT 0)
Looks like I'm going back on Lupron and the new drug called Apalutamide.....wish me luck!

On September 17, 2019, the Food and Drug Administration approved apalutamide (ERLEADA, Janssen Biotech, Inc) for patients with metastatic castration-sensitive prostate cancer (mCSPC). Apalutamide was initially approved in 2018 for patients with non-metastatic castration-resistant prostate cancer.
Posted 7/14/2020 3:07 PM (GMT 0)
Sorry to hear this Foxrun, hope the Lupron and ERLEADA keep the beast at bay for a logn time.
Posted 7/14/2020 3:14 PM (GMT 0)
Good luck with the addition to your Lupron. I looked up the cost of Apalutamide here in the US and I see its quite expensive--but I presume your Canadian health care system has you covered.
Posted 7/14/2020 3:59 PM (GMT 0)

Michael_T said...
Good luck with the addition to your Lupron. I looked up the cost of Apalutamide here in the US and I see its quite expensive--but I presume your Canadian health care system has you covered.

Apparently, it's free for now but that may change....my insurance covers the Lupron(which like $1200) .

Oh and here's my latest PSA.VIEW IMAGE

https://drive.google.com/drive/u/0/my-drive
Posted 7/14/2020 4:22 PM (GMT 0)
Good luck to you, Brother!
Posted 7/17/2020 3:15 PM (GMT 0)
I need some advice.....I had my Lupron shot Tuesday and can certainly feel the effect....I still have 4 of the Teva Bicalutamide tablets left......should I bother taking them?
Posted 7/17/2020 5:54 PM (GMT 0)
I was prescribed bicalutamide (Casodex) for two weeks prior to starting Lupron to prevent any testosterone surge as the body reacts to the Lupron. I'm not start enough to know if that would do the same thing concurrently with the start of Lupron. But given that you're dealing with a recurrence, it would seem like this is potentially important for you. I sort of think so, but I'm not expert enough on this...
Posted 7/17/2020 10:45 PM (GMT 0)

Michael_T said...
I was prescribed bicalutamide (Casodex) for two weeks prior to starting Lupron to prevent any testosterone surge as the body reacts to the Lupron. I'm not start enough to know if that would do the same thing concurrently with the start of Lupron. But given that you're dealing with a recurrence, it would seem like this is potentially important for you. I sort of think so, but I'm not expert enough on this...

I'm already into my fourth week and the Lupron has already kicked in and my PSA is down to 1.0, so I don't see the need.
Posted 7/20/2020 9:48 PM (GMT 0)
I was told to stop taking once I had Lupron shot.
Posted 7/20/2020 10:38 PM (GMT 0)

JDill said...
I was told to stop taking once I had Lupron shot.

That would make sense to me....
Posted 7/25/2020 12:40 AM (GMT 0)

Just like an old cowboy western, you've loaded up a double-barrelled shotgun with both LUPRON and APALUTAMIDE, and started an aggressive and proactive plan of attack.

"Bang! Bang!" ... against the foe ... the enemy.

Wishing you the best with your "double-barrelled shotgun" approach.

Here's to the fight, and to FIGHTING!

CYCLONE ~ # Iowa State University
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