Psa drop after 1st Luperon shotb

You should find a PCa oncologists considering the stats you presented. I had some lousy stats too back in 2002 with 12/12 biopsies all positive and psa of 46.6 then. It took 3 months of Lupron and I added casodex and proscar (ADT3), to get my low level psa number and then further months on it, before starting radiations as primary therapy. So, one month will not tell the whole story (perhaps) and it may take 2-4 months+ to see the lowest psa level. Of course exceptions exist in PCa, and various parameters from patient to patient. If you fail on these, it is possible to get responses on the estrogenic drugs: estradiol patches or gel, DES, or emcyt and they can work on hrpca cells, Further options in drugs can be tried, see www.hrpca.org     (proven treatments tab).

In high risk patients like us, we should look at everything and see all options possible. Look into Leukine, Zytiga MDV3100, Cabizitaxel, Radium-223 and similar, Ketoconazole, and others. Mets may require zometa and even Radium/Strontium/Samarium may be useful, spot radiations to eleve pain is done too. See the book Beyond Hormone Therapy by Mark Moyad too. Hope you have a significant drop in psa level and if so, is a good sign for the lower the better. Friend of mine did superb on casodex psa was higher than yours with high risk PCa, has been off the drug over 1 year now and psa is maybe getting to the level, where he may resume drug or take another, he took this one for little over one year originally.

Free online newsletter pdf files at www.paactusa.org  (see newsletters tab)

Zufus' reply goes a long way to answering a question I just posted, and I will also check into Raddad's Zometa reco, since we're dealing with bone mets. I've been worried about bone density. My husband was always a skinny white guy (which I've read is the worst case in terms of bone loss risk). He's holding steady on the whiteness but the skinniness just keeps coming.

Thank you all for your support .It has been only three months on our pc journey .I was doing really well with coping,but I see what everyone goes through when it is time for their psa results.
My husbands intial psa was 133.6 and his psa did come down to 40.24.I expected (praying for) a much lower result.

Zufus I am taking your recommendations and writing them down to discuss with our urologist .I have talked to my husband and he has agreed to bring in a medical oncologist .I was so glad when new VA dr. suggested it.Sometimes it just takes someone other than your wife to suggest something to make it sound like a good idea (that is a man thing).

Thank you Bud ,wish my arms were long enough to reach you and give you a big hug .Hope you can feel that big bear hug !!!!!!

Infohound,So glad you are here with me and now I am always here for you.


David. Thank you for your support and comfort.




Thank you to my husband and to all the brave men and women that served our country!!!!!!! Words can not describe my gratitude .

Want to tell you that urologists rarely endorse or use anything other than: LHRH (Zoladex, Lupron and such) or flutamides (Casodex and others in that family). Usually they ignore all other drugs, but oncologists do use those other drugs I mentioned and know all about them or should, uro-docs general do not and they are busy with the day to day long list of conditions and patients they serve and usually do not read up on the latest drugs like MDV3100, Zytiga and such. The uro treats various diseases and is not an expert in PCa, most uro-docs might be surgeons, but rarely do any other PCa major therapy.
His drop to psa around 40.0 is still a decent response for one month, so don't be totally discouraged.

 So, if the uro says those estrogenic drugs or others are junk, get another opinion because he could be biased or misinformed or under educated....this is common. Even the experts in PCa the specialists, sometimes not in total agreement on how to treat high risk cases, but more often they have the experiences and patient histories and some transparent things through internet, books, patients, forums or PCRI meetings and other things to display their expertise and experiences. Also, when is it not wise to get a second opinion or more on a life and death situation and quality of life situation?

I got 8 opinions up front and insurance company paid for it all, even when I fired some and switched to another....this exceeded my expectations and was a super learning experience as to what goes on, what types of claims and sales tactics might be used, etc. Mine was a real eye opener and sparked me onto the internet, books, forums immediately so as to see how 2 surgeons could have totally opposite opinions on me: one guaranteed a cure and 1% risk of incontinence (this fish questioned it all) and then, the other (Dr. Menon- more of the wise expert) denied me surgery and would not even consider it (because my stats were that bad, and would not result any possible cure) and the other 6 opinions all were in line with Dr. Menon and my 10 yr. history also proves out he was very correct. I also got some b.s. from one radiologist (actual lied about IMRT availability in Detroit) so she got fired one day before the zapping process was to begin (lol- filled out a survery and mentioned the lying thing, I noticed she was not working for them one year later, hhmmmm...) This stuff is not in books, but was a great incite into the unreal, real world of PCa. Good hunting to you.

Checkout www.yananow.net (patient histories and info site)      www.ustoo.org   (support groups nationally) www.prostatepointers.org   (groups/info)         (join)=  yahoogroups(hrpca).org
www.paactusa.org   (pdf file free newsletters online)

Post Edited (zufus) : 5/26/2012 6:31:30 PM (GMT-6)

Luci,

My uro is testing PSA and T/Free-T with each blood test. T is not interesting right now except as a baseline.

As I understand it Casodex blocks receptors, so keeps the PCa cells from being able to use T. Lupron blocks the production of T. So Casodex will not lower the T, but may lower PSA, while Lupron, if he is not already refractive, lowers T and (hopefully) PSA.

My uro and oncologist say that use of Casodex is only firmly indicated where there are mets that are currently, or seem likely to cause pain when the T flares at the start of HT. I see different opinions here, but it will depend on my insurance unless the docs define it as essential.

Different drugs, different purposes. My uro says 3 month PSA & T tests will be a part of life from now on. Both tests would seem needed to understand what is going on once HT is started.

Infohound,his bone mets caused alot of pain that is what drove him to the doctor.His pain went away almost a week after the Luperon shot and has not had any pain since except a little in the lumbar region when he first wakes up.He looks health ,works out,does everything he did before.He does have hot flashes and has gained a rubber tire around the midsection.I just have looked at psa drops on this site and others and it seems his drop is not as pronounced.I know everyone is different and I should not compare but being so new at this it is hard not to. Please let me know whatever info you learn.I will be praying for you.We have appts this week with family dr. and urologist so I will let you know what they say.We will be asking for a referral to an oncologist.I have on at Uc Davis that I would like to be referred. To.If not I may call him myself.....Best wishes.....

Infohound, my thoughts have never been anything but positive on your replies to my posts and nothing but grateful.

Thank you Lee,that helps a lot (no pun intended).it just seemed to me that all the stats on here and on yananow were almost undetectable after three months so I panicked a little.Am doing better now thanks to Hw family.
Will see what urologist says on Thrus and go from there. I am going to take Zufus' advise and bring in an oncologist. Will update when I know more.

Luci