PSAs After Lupron/EBRT/HDR

You might want to pick up Dr. Meyer's book on ADT, its pretty informative.

Good luck.

David

P.S. I considered the IMRT -HDR for myself, I believe it has substantial merit.

I pretty much had the treatment you describe. I am seven months out from my last Lupron shot and my PSA is steady. See my signature for details. My oncologist told me to expect a rise but so far so good. If you have other questions feel free to ask.

Best of luck to you.

Don

I would be lieing if I said I did not second guess. I think everybody does especially if the results are not as good as expeceted. But when I find myself doing this I go back to my original analysis and the conclusion is the same. For me, radiation offerred the best treatment option.

If Woody's PCa is localized you will find many scholarly articles that indicate the results of radiation are as good as surgery. (at least that was my findings) Surgery showed a slight edge for reoccurrance at the ten year mark but not any difference in overall survival.

My most recent signature had my PSA taken in June of this year as .32. That has been steady for the last year. I have another one coming up soon and will post it. My RO says that it will rise and thay what we are looking for is a stable reading around 1.0.

Best to you and Woody.

Don

My URO recommended my 2-3 year HT and my local ONC agreed with that without hesitation. My HDR ONC claimed(but did not want to over-rule other specialists) that there is no evidence to support HT for longer periods then one year. I actually convinced my own local ONC to go off ALL my HT's but when my HDR ONC heard of my decision he recommended that I stay on them for at least 9 months inorder for it to do the work it's designed to do.

This is what I was able to get in writing......

Gleason score of 9 on a 52 year old man is serious. We are dealing with aggressive cancer cells. Dr xxxxxx was under the impression you were going to be on hormonetherapy for a total of three years. In your case, the hormone therapy is given in the hopes of curing the cancer. If the hormones are stopped too quickly, you may not benefit fully from that part of your treatment. That makes me uncomfortable. A watchful eye means we resume hormones if and when the cancer returns.Then, it is most likely back with a vengeance. Hormones at that stage are no longer a curative option but a simply a means to slow down disease progression. I know this may not be what you want to hear but I am just trying tokeep it real. This may be something you want to explore further and certainly worth getting a second opinion on.

woodysgirl said...
This post has been revived and it seems appropriate to update at this time.  Woody's radiation ended in Oct 2010, his PSA did drop to .05 and most recently to .06.  He is still on Lupron but is having a great deal of difficulty with overall energy level and mental fatigue.  He works in school administration and typical day is not less than 12 hours and it is absolutely wearing him out.  There is no quality of life other than going to work and recovering from work.  He has decided that he will not take the next treatment which is due Nov 15.  Don, with your stats so similiar to his I follow your posts closely.  Knowing what you know now, would you have opted for the intermittent treatment from the start?  We are hoping the PSA stays down, but if not, 8 months on, 8 off doesn't seem near as bad as the continued treatment. 

That's the other part that confuses me, why bother with the PSA testing when on the HT? I was under the impression that the PSA readings, while on HT, will always be very low and inaccurate and that you have to wait for a period of time after HT before getting a true PSA reading?  

to see if HT is working.

ed

Said a different way - HT will eventually stop working, and you need to see that in order to find a different drug or treatment.

See Dr. Scardino's Prostate Book (2010 ed.), p. 480.

Thanks for the update on Woody. I think, based on the research I did prior to my treatment choice I would do the two year regimen. In fact I thought about doing a third year at the time as there were a few research articles that indicated better response in advanced cases. Note the work "advanced". That is the key to the length of the HT. In local cases the shorter term is effective. In Woody's case I would urge him to keep going. This is his best shot at having the HT whip this stuff. That is why I kept going the second year. The lethargy can be countered with a bit of exercise. Just take a 20 minute walk after dinner each day. Helps to quiet ones mind as well.

I recently restarted the lupron after a 16 month layoff. Darn difficult to do as I was beginning to feel normal again. So far the side effects have been clearing skin and disappearing body hair on legs, chest and arms. The hot flashes have not returned so far. (Knock on wood) I work out daily and recently lost 17 lbs of the 22 I gained on the lupron the last year.

One other thing. Keep an eye on Woody's cholesterol and blood sugar. Lupron causes metabolic syndrome and I am just digging out from that as well. Did not help that I have high cholesterol anyway but it is going my way so far.

WG I hope the best for Woody and you. He is lucky to have you in his corner.

Don