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landcrab47 · 04-14-2012, 12:27 PM

For those that remember my previous posts where I wrote that I started HT in Nov2011 when my psa was .6. At that time I was given three 3.75mg one monthly injections of Procren ( Lupron) at the same time. This turned out to be a big mistake, so I had a 11.25 mg three monthly injection approx one month later on 12/01 when my psa was .5.
Saw my urologist on 12/04 expecting another three month injection (psa was down to .2 testosterone was 1.0.)

Much to my surprise urologist said as my psa had stabilised at .2 he did not see any point in giving me a three month injection.
He said come back in October and if psa is raised he will continue with HT.
So after only four months on HT I go without treatment for six months. I thought the idea was to drive down the psa to undectable then perhaps discontinue HT.

I shortly off to Spain for an extended stay and I shall try to get a second opinion there. I cannot believe the treatment can be as bad as I have experienced so far.

Tall Allen · 04-14-2012, 06:12 PM

I think that a PSA nadir of .2 is too high this early in the game. If Lupron isn't doing the job, try Degarelix; if bicalutamide isn't working, switch to nilutamide; if finasteride isn't working, try dutasteride. Try higher doses. Everyone responds differently to those drugs, and thank God, there are enough choices out there that you can find the right drug cocktail and the right doses that works for you.

Can you find a urologic oncologist to work with?

- Allen

Johnt1 · 04-16-2012, 08:04 AM

Landcrab,
The goal of HT is to drive psa to .05 and keep it there for 6 months. If one drug won't do it then others like Casodex and Adovart shuold be added or swich to other types of drugs. HT should be monitored by an oncologist and not by a urologist.

Baptista · 04-17-2012, 10:17 AM

Torgeir

I agree with the above comments, the last PSA at 0.2 is still high. Some HT protocols try to keep patients at higher levels, such as the famous “cocktails” of Dr. Leibowitz but that is not a common practice of the majority. Moreover, your case belongs to the high risk group for possible distant metastases, systemic cases, because of failed radicals (RP and SRT).
In systemic cases the threshold of a PSA is usually kept much lower. Continuing the agonist shot will take you to those low levels and that should be the target to start your intermittent modality.

I thing that you are doing well in getting second opinions, Try to discuss about the protocol, the on-drugs cycle length and thresholds.

Similarly to you, I have also two failed radical treatments and started HT in November of 2010. The PSA was 1.0 and it went down gradually to a nadir of 0.02 (lesser than 0.05) on the 12th month. I just started my off-drugs period and my doctor informed me that I will go back to the Leuprolide shot (on-drugs cycle) when the PSA reaches the 2.50 level.
Here is my chronology if you are interested; http://www.healthboards.com/boards/cancer-prostate/879442-i-got-lower-psa.html

I hope you find a good oncologist in Spain.

Enjoy the sunshine and “La Vida Loca” of Malaga.

Baptista

landcrab47 · 04-18-2012, 12:47 PM

Thanks for the replies guys.
Baptista
I read your chronology a good result, I hope that your psa continues to stay low for a long time.
I will certainly seek out a oncologist in Spain, I feel my treatment so far has become a farce.

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