PSA rise from 20 to 30

Dr. Patrick Walsh, the most famous PCa surgeon that developed nerve sparing and literally wrote the book on PCa surgery, said famously that the only way he would operate on someone over the age of 70 required the patient to bring both his parents to the consultation for their approval.

I agree with Hal that it is far from mainstream to perform RP in any method on an 80 year old. Of course a surgeon can do so, but that doesn’t mean the surgeon should do so.

And listening to any urologist about radiotherapy would be like calling your electrician when your plumbing is backed up.

Hello, Abhinav ~~~

You are looking after your father's case, with great care, attention to details, and diligence.

Your father's oncologist will continue to lead you forward, and it is good to hear that your father has an appointment this week.

In my case, when the ADT shot was first started, I was given a temporary medication called CASODEX, to prevent "flare" ...

So --- this is a good topic that you have brought up today. Make a list of these questions, and bring the questions along to the appointment. That way, you will make sure you have everything listed that you wish to ask.

Even now, years later --- I see my oncologist every month --- and he knows I will always have a question or two to discuss, each time. Doctors are busy --- so I think through my questions carefully.

You have mentioned that your father is about to start on the medication called ABIRATERONE ACETATE --- that is the general name of the medication, and is also commonly called by its brand name --- ZYTIGA.

Many of us here have been on ZYTIGA --- now available in the generic form known as ABIRATERONE ACETATE, which is lower in cost than brand-name ZYTIGA.

I have been on this medication for over 5 years now, and it has been very helpful to me.

The combination of the HORMONE SHOT --- in addition to the medication ABIRATERONE ACETATE --- should work in power synergism together, to help your father.

For me --- and each case is different --- the impact was seen within the first month, after beginning the ADT injections --- and later adding ABIRATERONE ACETATE to my daily regimen.

Let us know how your father's medical appointment goes tomorrow --- and let us know how your father is faring.

With my best, to you and your father, in India ~~~
Cyclone ~ # Iowa State University

Hello, Abhinav ~~~

We have a very extensive and insightful thread on ZYTIGA, which will give you and your father tremendous background and insight.

ZYTIGA is the brand name for ABIRATERONE ACETATE, which has now become available in generic form, here in the United States.

I think you will find the thread VERY helpful --- I just "boosted" it to the top of the feed, a bit ago, so you will see the thread entitled "ZYTIGA: OUR COLLECTIVE EXPERIENCES" on your computer screen currently.

I am on the same dosage as your father --- 1,000 milligrams per day. In my case, the dose is in the form of four 250 milligram tablets, which is EQUAL to your father's dosage of two 500 milligram tablets.

My doctor instructed me not to eat anything for 2 hours before taking the medication --- so, when I wake up in the morning, I start my day with this medication. Then, I was told to not eat anything for 1 hour after taking the medication.

Once you build the ritual, it is easy to follow --- and for me, taking the medication first thing in the morning works best for my daily routine.

I have found that drinking some WATER first, before taking the medication, is very helpful --- and drinking water after taking each pill --- and some more sips of water AFTER I finish the pills --- all of this is helpful to me.

Once, I "wolfed down" the 4 tablets, in quick succession, because I was in a hurry. I failed to drink enough water after taking each tablet --- and this mistake resulted in nausea that morning.

So --- I always remember to drink water first now --- take a tablet --- drink some more water --- wait a bit --- drink some more water --- and then take the next tablet --- and then drink some more water after that. My lesson learned!

I have been on ABIRATERONE ACETATE ("ZYTIGA") for nearly 6 years now. I give humble thanks, each day, for the ways in which this medication has helped me maintain my health goals.

I started saving the empty prescription bottles, each month, as a way to mark my progress on this medication --- and as a way to deepen my gratitude for the breakthrough medications which have helped many of us on this website.

All the empty bottles are lined up on a shelf --- and soon there will be six years' worth of bottles lined up!

On the national news, the corona virus situation in your native country of India is currently being featured --- so I hope that you and your father are staying "safe and sound" in India.

My main doctor is from India, and he is a GODSEND to me.

Please know that I am thinking of you and your father ---and you are in my thoughts --- and the United States is now sending medical aid and medical equipment to India, in recent days.

Both of my parents had corona virus last fall, and my father was in need of oxygen for two months, while in the hospital ---- so I know the importance of medical care and medical supplies.

Please keep us updated --- and let us know how your father is faring!
CYCLONE ~ # Iowa State University

Good evening.
One question please:
We had the blood work done today. After the first ADT shot(3 month shot) about a month ago, the PSA has come down from 43 to 7.5. When should I expect it to reach the nadir?

Hello, Abhinav ~~~

I always follow your posts, and I am thankful to read your latest update on your father.

In my case, with an initial PSA over 100 upon diagnosis, my first ADT shot was given immediately --- I started with LUPRON hormone deprivation shots.

After one month, my PSA tumbled down from over 100, to less than 10.

To go from "triple digits" down to "single digits" --- in one month --- seemed miraculous, in that moment. Treatments were BEGINNING TO WORK! It brought me renewed HOPE ------ and some much- needed encouragement!

It's encouraging to see the decline in PSA values in your father's case.

Each case is different, but your father is also taking ABIRATERONE ACETATE, and that should be working synergistically with the ADT shot.

Time will tell, but let's hope that your father's PSA continues to tumble downward. Your father has experienced a significant decline in PSA.

My oncologist wanted to monitor everything very carefully, and so we began monthly labs. I think this same approach would be beneficial for your father's case.

The monthly lab reports allowed us to build data, track trends, and watch for the lowest nadir value achievable in my case.

When I started ADT shots, my doctor explained that the shots would begin to "starve & strangle" the hormone sensitive cancer cells.

Those cancer cells were slowing "starving and strangling" themselves to death, because they were being deprived of TESTOSTERONE --- which is their "fuel" for survival.

I found that visual description very encouraging --- and it helped me understand the decline in PSA values.

So, visualize those pesky cancer cells "starving and strangling" right now!

I am THANKFUL to read of the noticeable decline in your father's PSA scores!

Please write again soon, Abhinav, with further updates in the near future.

I have been thinking of you and your father in India ---and here's to further good news at his very next doctor's appointment !

With my very best, from across the miles --- from IOWA to INDIA ~~~

CYCLONE ~~~ # Iowa State University

Hello, Abhinav ----

Thankful to read your update from India. I have been thinking of you & your father!

I am thankful you are recovering from corona virus now. My parents and sister all had corona last fall, and so I am mindful of you.

My local oncologist is from India, and we discuss the healthcare crisis that has emerged in his native homeland. He is a GODSEND to me.

In regard to your question --- I am encouraged to read of the noticeable drop in your father's PSA levels.

It's obvious that these treatments are having a positive impact. It's a GOOD DAY to read this GOOD NEWS from you!

You asked if you can expect your father's PSA to go down to zero, by the end of July. Each case is different.

These are early days in your father's treatments. I think it's important not to fixate on a certain PSA level, but rather to keep watching for more declines, over time.

Sometimes, my PSA decreased in tiny increments, when I initiated treatments. My doctor emphasized that these "little bits of good news" were important to CELEBRATE --- because they instill hope and encouragement.

Over time, I realized that treatments are akin to a long marathon ---completed over the course of time --- and not a short sprint race.

I hope maybe my revelation gives you a visual image of your father's treatments --- it's a journey --- a marathon --- stretching into the future, over the course of time. Focus on the good news shared recently by your father's doctors --- and keep facing forward and looking ahead.

Drilling down into the question you asked ...

Often, some stubborn, residual cancer cells remain. It's difficult for most fellows to reach an absolute ZERO on their PSA test. Focus on the decline, and celebrate that!

This is the PERFECT time to build that bond with your father's doctors. Encourage your father to ask questions each time. Encourage your dad to build a connection and positive rapport with his doctors. This will serve him well in the future.

Meanwhile, your father will want to keep seeing his doctors on a regular basis. Keep track of those PSA trends.

Do you accompany your father to medical appointments?

It's important to encourage your father during this time. He likely has worries, fears, and anxieties on his mind. This is part of a health diagnosis, such as prostate cancer.

Right now, you have some GOOD NEWS to celebrate with him!

I was so happy to read the good news you shared in your latest post. Let your father know he has others THINKING OF HIM --- and wishing him well!

Keep in touch with us here -- I hope you are feeling better each day, as well!

With all my best, from across the miles ----
CYCLONE - # Iowa State University

Hello, Abhinav -----

I hope you have fully recovered from corona, as the weeks have gone by ---- and hope that your father is doing his best and faring well.

How have your father's medical appointments gone, in recent months?

I wanted to let you know you have others thinking of you and your father, from across the miles.

Sending my best wishes to you and your father in India ~~~

CYCLONE --- # Iowa State University

Hello, Abhinav -----

I am VERY happy to hear the news of the decline, and downward trend --- of your father's PSA score!

I know you and your father have been following up with your father's medical team. These PSA scores are a SURE SIGN of treatment success!

I hope you and your father have been CELEBRATING these signs of GOOD NEWS, along the way!

Treatments can be a rocky road to travel upon, and it's important to celebrate good news, along the way.

Your father's PSA score has REALLY tumbled down significantly, since we first heard from you! Hooray! Hoorah!

When my oncologist orders lab work and PSA tests, he ALSO orders a testosterone test, to make sure the ADT injections are doing their work. In your father's case, you want to ensure that your father's testosterone is staying LOW.

You might ask your father's doctor to run a simple testosterone level test.

Residual testosterone can "fuel" the proliferation of residual prostate cancer cells --- so make sure your father's testosterone levels are staying low.

My oncologist now reports testosterone levels to me, every time a new PSA test is conducted. Both tests are important, for cases like your father's case and mine.

I felt this was something important I could share today with you and your father.

Your posts are always important to me. You are such an advocate for your father and his well-being. You are looking after him, serving as a source of encouragement, and helping him achieve his healthcare goals.

The news of a cancer diagnosis is never easy, but it can draw family and friends TOGETHER in new and MEANINGFUL ways, like never before.

I also value your posts and updates from INDIA, because it reminds me of the far-reaching impact of this website --- reminding all of us that we have readers and members here ALL ACROSS THE GLOBE.

Stay in touch with us here --- your father's latest PSA scores, now registering in the low decimals --- are TREMENDOUS NEWS!

My very best to you and your father ~~~ please let him know he has others wishing him well and thinking of him today!

Thankful for the GOOD NEWS you shared ~~~
CYCLONE ---- # Iowa State University

Hello, Abhinav ----

Good to hear from you, in regard to your father.

Like your father, my case started with a high PSA, with complexities.

Each case is different, but your father just started ABIRATERONE ACETATE (Zytiga) in May 2021.

The PSA scores you shared since then have been 7.5 .... then 2.3 ... then 0.02 ... and now 0.07.

None of us here are doctors, but I feel that your father's new medication is working, and I would want to ensure that he continues to track his progress on this new medication.

I have been on the same medication for over 6 years now. A couple of years ago, one of my doctors asked if I wanted to take a break from ZYTIGA. I stated that unless something changes, I would not want to walk away from the medication that continues to help me.

Your father's PSA began to tumble down when he started ABIRATERONE ACETATE just a few months ago. I personally would want to continue taking the medication that seems to be helping. These are simply my personal thoughts.

There's quite a few of us here on this website who have taken ABIRATERONE ACETATE (Zytiga) for years, and it has helped us immensely.

With your father's worrisome PSA levels from the beginning, I think it's important to do all you can to keep his PSA levels low. These are just my thoughts.

Was there a strong REASON why your father's doctor is recommending this change, after just a few months of being on this medication which started helping him immediately?

Since you seem to have concerns, and valid questions ---- can you get a second opinion from another trusted doctor?

I have two trusted oncologists who look after my case.

A second medical opinion from another trusted doctor might help lead you forward on this important question about a change in medication.

Please keep in touch --- I hope you and your father are doing well in India.

I will watch for your future posts and updates, Abhinav ...

My best to you and your father ----
CYCLONE --- # Iowa State University

I think there is some current research about intermittent therapy being more effective, taking a break and only treating on a PSA rise. Have a look, or others may chime in.

Hi Cyclone, everyone

Got the blood work today and the PSA is now 0.09.

So the following is the chronology of the PSA readings over the past few months:
7.5 -->2.3 -->0.2 -->0.07-->0.09(today, with a break of abiraterone for one month)

Please take a look and share your inputs.

Has your Dad had any treatment other than this ADT at this point? I have lost track in this thread but it seems that was only discussed. ADT does not "cure" so wondering what the full plan is now? Did the doctors ever resolve his bone scan regarded possible spread of the cancer? His numbers look real good which is great.

Hello, Abhinav ----

Your father has come a long way, since diagnosis! It's nice to see his PSA down in decimal levels.

Is he going back on ZYTIGA (Abiraterone Acetate) sometime soon?

My oncologist has me visit the lab each month, to track PSA levels carefully. I think your father needs to visit the lab frequently, too.

Also --- have your father's doctor request a testosterone test. You want to ensure his testosterone is low --- because that fuels prostate cancer.

In my case, LUPRON and FIRMAGON did not suppress my testosterone levels, so I am now on ZOLADEX --- another form of ADT injection. It helps keep my PSA in check.

Has your father's doctor ever discussed RADIATION or CHEMOTHERAPY? Your father --- like me --- had a high PSA at diagnosis.

My toughest treatments (chemotherapy and radiation) have paid the greatest dividends, over time. My health treatments are listed beneath my signature at the bottom of this post.

Wishing you and your father all the best in India ~~~
CYCLONE - # Iowa State University