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Posted 7/22/2010 4:07 PM (GMT 0)
Well i went in for my PSA this morning and it came back at .71 which is up from .17 in March just three months ago. Needless to see my doctor was concerned as was I. I suppose the good news is that I stopped HT one year ago before I was resistant which should mean I can go back to that. I have opted to have another PSA test done in 60 days before deciding on treatment. My question to my friends is this, do you think I am making the right decision?

peace to all

Dale

Posted 7/22/2010 4:24 PM (GMT 0)
Dale - sorry to hear the numbers rose for you -I don't know if to expect the rate to continue exponentially - or maybe it is just a blip? - so a two month wait doesn't look too much of a risk -
-maybe a second opinion on the time delay for the next PSA test?
-wishing you all the best.
BRONSON
Posted 7/22/2010 4:31 PM (GMT 0)
Dale I don't know much about the HT, but I remember reading awhile back that Tony said he was going to wait until the PSA reached the 2.0 mark before going back on HT. Based on that only, seems like waiting for another test would be reasonable.

Hang in there Prez....
Posted 7/22/2010 5:03 PM (GMT 0)
Dale, my only personal experience with HT is the discussions I had with my Onco about my PSA after the IMRT. It was jumping around up to 1.5. Tests showed they found a MET and I am addressing that with the RO today. But in that last meeting with my Onco he said we would hold off discussing the HT scenario for three months and in fact didn't want to do any PSA tests for 3 months.

Good luck man. I guess my only question is "What is your comfort and experience level with your Dr?" Sounds like you guys have a long relationship and if the comfort level is in place, maybe you go with his direction and try not to stress for the next 60 days.

Blessings upon you brother,

Sonny
Posted 7/22/2010 6:19 PM (GMT 0)
Dale, sorry about the rise. Thanks for the update.

The wait, from what little I know, sounds okay ---- but, I'm the last person you'd want to take advice on this from. I'll be watching for an update. Good on you!

Sheldon AKA Sleepless
Posted 7/22/2010 8:57 PM (GMT 0)
Thanks for the responses
Sonny you ask if I was comfortable with my doctor and yes I am. I feel lucky to have a doctor that I have such a good relationship with. His advice was to wait and get one more reading under our belt before any major decisions were made. I am happy with that right now.
Les, I have kinda made my personal marker around the 1.5 to 2 range however I was hoping to not have such a huge jump at once. At this rate I will hit that number in Sept. Oh yes I plan on staying the PREZ haha
Bronson you are always a pleasure to hear from thanks for the response
Sheldon your advice is better than you think so don't cut yourself so short.

You guys are awesome

Dale
Posted 7/22/2010 9:03 PM (GMT 0)
Dale,
Sorry about the rise n your PSA. I don't much about HT but from everything I have read, waiting 2 month for another test sounds like a good idea. I wish you the best.
Posted 7/22/2010 9:12 PM (GMT 0)
Dale,
Sorry about the rise. I think you are doing the right thing. Please read "A Primer on Prostate Cancer", by Dr Stephen Strum. There is a lot more monitoring and testing to see if the HT is working or it is the right combination. Most doctors give you a shot of Lupron with out any futher evaluation except PSA .
JT
Posted 7/22/2010 9:35 PM (GMT 0)
Dream,

Has your doctor considered the possibility that the Lupron you're on now may have failed to control the generation of testosterone and that he should consider another drug?  For many men, some HT drugs just don't seem to work while others are very effective.  It's not surprising to me that your PSA is rising if your testosterone is going up so quickly.  A rapid rise in testosterone levels could be an indication of a more aggressive form of cancer.  Does your doctor measure dihydrotestosterone?  It is much more powerful in stimulating prostate growth than testosterone but many doctors don't routinely measure it and and it may well be rising too.  From what you have described, the rapid rise in your testosterone level may be a strong indicator that Lupron isn't working for you.

It would be interesting to plot the times you started and stopped Casodex and Lupron against your testosterone levels and PSA.  From the data in your signature, it looks as if you reached the lowest PSA about 12-15 months after your IMRT which is reasonable.  Frequently following radiation there is a PSA bounce at about this point before PSA levels decline again to some low level nadir.   If you stopped taking Casodex about that time and switched to Lupron and your testosterone and PSAs began to rise it would make me very suspicious about the efficacy of the Lupron in your situation.   You may wish to discuss with your medical team an alternative mix of drugs in your androgen therapy.

I'm certainly not an expert in this area but I studied it during my research before treatment.  Hope you get some answers soon.

Posted 7/22/2010 10:17 PM (GMT 0)
Dale, my friend, I am disapointed for you with this rise, and I think waiting for another reading is sound advice, before re-activating the HT path. No easy answers in your particular journey, so being comfortable enough with your doctor is important at this juncture. I wish you peace of mind and soul in between the PSA readings, I know, easier said than done. We are all here for you. Strength in numbers.

David in SC
Posted 7/23/2010 2:05 AM (GMT 0)
Livin,
I wish you all the best.

Hero
Posted 7/23/2010 5:40 AM (GMT 0)
Hi Dale,

I'll kick in my support as well. I like your plan to get one more reading to know where you're at before making big plans.

All the best to you.

Barry
Posted 7/23/2010 6:03 AM (GMT 0)
Dale, thanks for the nice comment about my advice, but I know so many here are so much better informed than I when it comes to medical matters I want people, especially new people, to not give my advice, or thoughts, when it comes to medical decisions much weight --- especially when compared to so many others here. This is being realistic. Not modest. I assure you my ego ( Edging God Out) is intact and I'm normally a pretty arrogant know it all.

But still, thanks.

Sheldon AKA Sleepless
Posted 7/23/2010 7:02 AM (GMT 0)
Hi Dale,
You have done remarkably well and I think you have a great path, buddy. .7 is still within range of monitoring. Have you decided what may be the next step? Lot's to choose from. It's been a good year so far with the new options for PCa treatment. We have to take this all one step at a time, but their are so many steps.

I love you buddy, and may the good Lord keep you close. Call anytime if you want to chat...

Tony
Posted 7/23/2010 6:29 PM (GMT 0)
Tony
I have not considered what to do next, however let's say my PSA goes up in 60 days again I think I will go back to ADT3. It worked in the past and I am sure it will work again. Might be work as long. Honestly I have been so focused on training for a triathlon that I am not up to date on the latest treatment protocols. May I ask what your thoughts would be? The down side to ADT3 is the darn side effects that I now know. Oh well it was not bad being a girl haha.

peace and love to you all
Dale
Posted 7/23/2010 10:17 PM (GMT 0)
Dale,
Talk to Zufus about his approach. You may be able to avoid the LHRH downer in the second round. Bob is very familiar with the DES protocol and you can't argue with his success with it. I know it doesn't work for everybody, but you are in terrific shape physically and can do just about anything in the protocols. If I fail, I might go that way. My oncologist, Nick Vogelzang, isn't against it but he said he would like to look at other options too. The good news is that you have lot's of options.

Now that my T levels are back up, it sure is nice being unreasonable again...lol

Tony
Posted 7/23/2010 11:56 PM (GMT 0)
Hi Dale,

Sorry about the rise. If I have read your dates right you are about three years out from radiation. You may be seeing a "bounce". What did your RO tell you was a good number to stabilize at after radiation? Mine said something around a 1.0 and to expect the PSA to rise after coming off the lupron.

I am researching alternatives to going back on HT and, as Tony recommended, I am looking at DES also. Just seems that all I can find is for vetrinary use. I guess I should bark next time I see the doc. :)

Dale, best to you and keep us informed of progress.
Don
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