Posted 1/14/2021 10:04 PM (GMT 0)
John, it could be a bounce or cancer, not enough information to know which it is yet. If you follow the trend for awhile and see the PSA reduce, then it would indicate a bounce and not cancer. If you follow the trend and it keeps going up and up that will indicate cancer. At some point certain scans might find evidence of cancer.
You should expect to have a positive PSA since you have the prostate. What level might that be in the absence of cancer? Don’t know as every man is different. Some are undetectable like I have stayed, others could be 2 or 3 and stay there for a long time.
If it is cancer, then ADT would likely arrest the cancer and you would know that by a decreasing PSA. Often when using ADT you will start with casodex to offset any testosterone flare/increase brought about from the initial dose of Lupron or Eligard. If you use Firmagon, it does not flare so no need for the casodex.
The duration of the shot is generally based on the total period of time you expect to be on ADT. When I started the plan was for three years so we used six month shots for convenience. You are referring to intermittent ADT where you go on and off in the management. Generally you would start with 6-9 months for the initial period to get the full effect of ADT. Then you would go off and monitor PSA every quarter. If it stays down, you stay on the “ADT vacation”. When the PSA starts moving up indicating growing cancer then you get another shot. I haven’t seen anyone start with three months on and then go off, but that is really up to your doctor to determine.