HealingWell
Search Close Search
☰

What does my psa level suggest ??

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 8/24/2011 10:47 AM (GMT 0)
Would appreciate some good straight talking here please guys !!!

Ive been on adt for some 10 months now and psa as gone as follows

144 at dx to 20.....13.......3.......2.5 at present psa taken every 3 months

I was told that i should have had an untraceable psa after 3 months ???

Doc added 50 mg cosadex to my meds which i havent taken throughout the summer as i was sick of the hot flushes. I am very active at 45 years of age and still work very hard in the gym (cardio now as weights seem to get heavier just by looking at them now)What is my 2.5 psa telling me after 10 months on zoladex ???? would it suggest that pca is still growing ?? confused

Posted 8/24/2011 12:12 PM (GMT 0)
leeanglo,

I am not sure if this is an apt analogy but when men have RT+HT the PSA does not typically go all the way to zero. I think there is usually a small, non-zero nadir, like yours. So, with only HT, I am not sure a pure zero is realistic or to be expected. However, it could also mean there is some androgen-independent cancer present. To know more, I think you have to wait and monitor any increase from this point over time. If it stays at 2.5, then great. If it starts the tell-tale doubling then the cancer is likely growing again. Again, you will have to take PSA measurements over a period of time to see a doubling trend, if there is one.

Very straight talk questions here: You are 45 years old with advanced PCa. Have you checked with a radiation oncologist about lymph node radiation and radiation to any mets? I notice you are M1. Do you know how many mets you have? Can you find them? If there are, say, less then 5 mets, an aggressive approach might be to radiate them.

Posted 8/24/2011 12:43 PM (GMT 0)
Perhaps taking the casodex will get you down to an undetectable level.
Posted 8/24/2011 1:20 PM (GMT 0)
Have they checked your "T" level to be sure it's below castrate level? The drugs don't work for all men..You want your testosterone to be below 20 and hopefully below 10..

Many doctors and researchers feel that PC patients all have a certain number of hormone-independent cancer cells right from the start. So it's VERY difficult to get PSA down to undetectable with hormone therapy alone...
Posted 8/24/2011 1:52 PM (GMT 0)
Being high risk, I hope you are working with a medical oncologist that specializes in prostate cancer and treats a lot of advanced cases. I remember that you are in the UK. In the states, we have a number of renowned oncologists (names of whom you will see on this board) and some are now introducing chamtherapy earlier in the treatmnent schedule with success. Dr Snuffy Meyers is one that is introducing chemo at an earlier date in some advanced cases.

I would be studying up on that and other more novel treatments by doctors like Meyers, Oliver Sartor at Tulane University in New Orleans, Dr Scholz and Dr Liebowitz, both in California. Then discuss with my med-onc. Also check in on the websites that deal with more advanced cases, I think one is www.hrpca.org and another is www.paactusa.org. Another website with great info and links to more advanced treatments is www.prostate-cancer.org.

If you still have your prostate (I don't remember you haveing surgery) then it will still give off some PSA so getting to zed may not be possible. Doctors like Meyers have the ability for you to send in your situation in an ask the doctor setting.
Posted 8/24/2011 2:24 PM (GMT 0)
Once again Guys thanks for imformative posts.Just to answer some of the points that have been raised........My prostate is still intact and the bone scans showed mets in pelvis, spine, 1st and secondry lymph nodes 2 ribs and uper neck vertebrae.No mention as ever been made to checking T levels so on one of my psa blood forms i included a request fot T and it came back at 5 so i presumed i was at castrate level.I have no input from any oncologist here in the uk !!!! The practise here seem to be continual adt and then Chemo.No forward bone scans seem planned by the Urologist that looks after my care and 3 monthly psa checks with a chat with the Urologist seems to be standard care policy.I have a meeting on 7th september and i want some answers from my udoc about rescans to see how the mets are looking and id also like to know about availability of abireterone here in the uk and looking further forward id like to be considered for xl184 as this seems to be the only newbie drug thats doin anything to bone mets.Radiation treatment was ruled out at the very beginning of my treatment !!!! Maybe the radiologist didnt fancy my chances !! He did state that it was not possible to radiate the nodes higher into my abdomen so maybe they thought theres no point doining half a job if i cant be cured.
Posted 8/24/2011 3:02 PM (GMT 0)
Lee,
The answer is you have an aggressive cancer that is not totally responding to androgen deprivation. When diagnosed with metastatic disease, resistance to treatment in the form of androgen independence can be a factor. I see your testosterone level is in the castrate level at 0.5 nmol/L. You might consider adding some estriol(E3) cream to your protocol to see if it helps with the hot flushes. Also consider asking for your dihydrotestosterone (DHT) blood level. If too high (more than 0.9 nmol/L) ask for a prescription of Proscar (or Avodart) to be added to your Casodex + Zoladex therapy.

Although not achieving a low PSA nadir in general conveys a poorer prognosis, you are young and in good physical condition to fight the disease. Exercise and a healthy diet can go a long way in slowing down cancer progression. You might ask to have your calcidiol blood level checked. If below 100 nmol/L, ask your doctors to supplement with cholecalciferol to raise blood level to a minimum of 100nmol/L. This has the potential to slow down disease progression.

I wish you the very best possible outcome,

RalphV
Posted 8/24/2011 4:09 PM (GMT 0)
Lee,
There are many meds that will help with the hot flashes; ask your doctor about them. Patients that have their psa drop to .05 and hold for at least 3 months are getting a favorable response to HT and HT will work for a long period. Your psa levels indicate that HT will not work for very long. As others have indicated you should be seeing a medical oncologist. The Prostate Cancer Research Institute's web site has a section devoted to advanced cancer and things you can do to aliviate the side effects of HT.
JT
Posted 8/24/2011 5:06 PM (GMT 0)

leeanglo said...
Would appreciate some good straight talking here please guys !!!

Ive been on adt for some 10 months now and psa as gone as follows

144 at dx to 20.....13.......3.......2.5 at present psa taken every 3 months

I was told that i should have had an untraceable psa after 3 months ???

Doc added 50 mg cosadex to my meds which i havent taken throughout the summer as i was sick of the hot flushes. I am very active at 45 years of age and still work very hard in the gym (cardio now as weights seem to get heavier just by looking at them now)What is my 2.5 psa telling me after 10 months on zoladex ???? would it suggest that pca is still growing ?? confused

Leeanglo....not sure but I was told same thing...Im on day 45 now and I went from 94 to 56 to 31 to 17 to 7 as of last week. Just did more blood work today. I was also told by my clinical study doctor that I should have had all the side effects by now after 45 days of being on Lupron...but many here say they had effects show up after 6 months or a year.

Ive seen so many different views, opinions and data that differ so I just take it as it comes. I guess the good thing about a study is that they check me every week so I can better track progress.  If I ever stop trusting my Doctors, I will change them out but Im already on my 3rd and I trust them.  I was told that it could take months to get your PSA down to zero who knows. I may be there by next week.

It sure would be nice if there was a little more consistency among doctors.

✚ New Topic ✚ Reply