Finally some good news -- but some questions

Today my pharmacist called and said it was approved. Yesterday, I had searched to see what the cost of Casodex would be without insurance. The prices ranged from about $600 to $88 for a 90-day supply. What a pain shopping around.

Now that it has beem approved, the cost for me is $10 for that 90-day supply, and ditto for Femara.

So, I was ready to get started (phone consultation with Dr, Lam first on Thursday). But then I got my PSA result.

Here is what I posted elsewhere:

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OK – just some brief background information.

I was dx. with PC 12/2/2009.

I failed surgery and then failed SRT.

After SRT, my PSA’s have been:

2/23/2012 3.43 PSADT--3.19 mos. for last 12 months figures
1/6/2012  Started Avodart
12/22/2011 1.97 Continuing 3.08 months calculated PSADT
11/1/2011 1.38 Looking for sure like HT
8/11/2011 0.75 Confirm failure -- looks like HT if it goes above 1.0
7/11/2011 0.6 Looks like SRT Failed

I  was hesitant to start HT and Dr. Lam suggested I try just Avodart. Basically, he said to consider it the “off cycle” of HT and we would see how I did. As you can see, it appeared not to work.

After my 3.43 PSA, we decided I would get one more PSA a month later because the 3.43 PSA was done a few days after major surgery (I had a gangrenous/necrotic/severely inflamed gall bladder – it was BAD). Anyway, I was wondering if that last PSA boost might have been due to that inflammation. I think my doctor was skeptical (remember, I don’t have a prostate).

Dr. Lam said if my PSA increased further (he gave me some leeway to 4.0) we would start the triple blockade.

Fast forward to today. I just did another PSA. and I was shocked at the result: 2.28.

Frankly, after all these PSA increases, I fully expected to start HT. So, now I get a month reprieve until the next PSA.

However, could the avodart be masking a greatly increasing PSA? I know with a prostate, one often doubles the number to get the true reading. But I don’t think that is true after surgery. Does anyone know? Also, I’m wondering if the surgery/inflammation did increase the PSA on 2/23/12. I have to assume that the avodart is working.

Bottom line is that eventually the PSA will rise again and I will have to commence HT, but I am pleased at this decrease. Perhaps this augurs well for when I do get on HT?

Any comments/insight would be appreciated.

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Anyway, folks, I expected another gut kick, and FINALLY I got a pleasant surprise!

Despite the questioning tone above, I am THRILLED with this most unexpected result!

Mel

I emailed Dr. Lam and he said to test again in one month. So, although I would prefer 3 months, 1 month it shall be.

Get this: I called to cancel a follow-up April appointment with Dr. Hussain at Umich.

They just took a message and then called back to confirm the message and they will deliver it and I should expect another callback from them.

I HATE THEIR COMMUNICATION METHODS (compare that to Scholz/Lam!)

Mel

I fully intend to monitor my PSA every 30 days. I think studies indicate it is best to do the triple blockade, so the next change in tx will probably be casodex plus lupron (maybe after a week of casodex) and then stay on the triple blockade.

Mel