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psa rise on lupron

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Prostate Cancer
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Posted 10/26/2009 3:07 AM (GMT 0)
Has anyone out there had this situation? psa 107 , gleason 8. April 2007 Started on Lupron(every 4 months, casodex for 2 months. Radiation Oct 2007. PSA decreased to .3 than in april 09 psa started to rise to 3.1 started on casodex , psa fell to 1.5 by August. will see oncologist again in Dec. Why would my psa rise and than drop with casodex. Does it mean the radiation didn't work? Asked my oncologist and he really didn't give me an answer.
Posted 10/26/2009 4:06 AM (GMT 0)
Kak,
A reoccurrance after radiation is defined as 3 consecutive rises in psa. If psa does not fall to under .05 on Lupron or Casodex it means that there is a high population of androgen independent PC cells vs androgen dependent cells. (the casodex and lupron only work on the androgen dependent cells and the androgen independent cells keep growing.) I would get a 2nd opinion from another oncologist that specialized in only prostate cancer.
With a psa of 107, a G8, and if they radiated the lymphnodes it is highly likely that it was not contained in your prostate. Your doctors should be communicating more with you about your status and it seems they are not. You have the right to answers.
JohnT
Posted 10/26/2009 5:52 AM (GMT 0)
Casodex is an anti-androgen. It works at the cell level and prevents the cell receptors from attaching themselves to testosterone or dihydrotestosterone. The Lupron prevents the bodies production of these androgens, but not fully. So what little is there is allowing the cancer to grow. The anti-androgen, Casodex, is working, but it won't forever. Still, varying the combinations can bring the PSA back down. If the Casodex stops working, then Nilandron or Keto could be a next step, and the Casodex can later be re-attempted. Stay positive and hopeful. Many things to try still...

Tony
Posted 10/30/2009 1:24 AM (GMT 0)
I have been gone for a few days and missed this post. Kak I am sorry you are dealing with this situation. John T and Tony offer some expert knowledge and i would encourage to heed the wisdom. My little tidbit to offer is to stay positive and vigilante in the battle. There are still plenty of weapons to fight with. Keep me posted on how you are doing my friend.

peace and love
Dale
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