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landcrab47 07-08-2012 02:18 PM

Three Month Lupron Injection
 
Iím due to have my third three month Lupron injection in approx two weeks. I had my psa and testosterone tested a few days ago. Psa was 0.1 and testosterone was 0.2.

As my testosterone is below the castrate level, is it necessary to have the next injection as planned. Itís obvious that the three month Lupron injection suppresses the testosterone longer than three months.
Would it not be better to monitor the testosterone and apply the injection when a rise is indicated.

One other point how long can one expect before psa is reduced to undedectable when on HT. As my last two psa readings have been 0.1 I did expect the latest to below 0.1.

Baptista 07-09-2012 04:52 AM

Re: Three Month Lupron Injection
 
[QUOTE=landcrab47;5015129]I’m due to have my third three month Lupron injection in approx two weeks. I had my psa and testosterone tested a few days ago. Psa was 0.1 and testosterone was 0.2.

As my testosterone is below the castrate level, is it necessary to have the next injection as planned. It’s obvious that the three month Lupron injection suppresses the testosterone longer than three months.
Would it not be better to monitor the testosterone and apply the injection when a rise is indicated.

One other point how long can one expect before psa is reduced to undedectable when on HT. As my last two psa readings have been 0.1 I did expect the latest to below 0.1.[/QUOTE]

Crab

In principle, the hormonal treatment is done with a defined protocol. Alterations should be done with intent in controlling the cancer not the treatment. In saying that, the control on T in the overall context is merely done to check for medications effectiveness in the castration status. Other androgens are still active so that the control on T would not provide an excellent management. PSA will be the regulating marker of cancer’s treatment progress.

The threshold in “switch on/off” drugs is therefore defined in the protocol according to PSA levels. Your doctor is the commandant of your case and he may have decided the period of your remission status. Some doctors by experience prefer to have their patients on remission levels for at least one year before switching OFF the castration status. Dr. Myers likes a threshold of PSA<0.01 but other remarkable specialists choose a PSA<0.05. This is my doctor’s threshold too.
There are also famous specialists that try to keep their patients (not all of them but advanced cases) by holding the PSA in much higher levels of about 2 to 5 ng/ml.

In any case, it seems that guys on remission for at least one year before stopping to take the drugs do better than those on shorter periods. Many HT survivors report reaching their nadir PSA on the 12th month point; however, the period also depends on the HT protocol (ADT 1, 2 or 3).
Results among patients vary because we are not equal too.

My experience on the levels of the markers since starting HT was this;
Nov 2010 PSA=1.0 ng/ml ; T=3.76 ng/ml (Cyproterone 50 mg-1 month plus Eligard 6-month shot)
Dec 2010 PSA=0.18; T=0.28
Mar 2011 PSA=0.07; T=0.28
May 2011 PSA=0.05 (remission) (Eligard 6-month shot)
Aug 2011 PSA=0.03; T=0.33
Nov’2011 PSA=0.02; T=0.32 (Eligard 6-month shot)
Feb 2012 PSA=0.02; T=<0.10
May 2012 PSA=0.02; T=<0.10 (End of Eligard 6-month medication effect and stop of administration of drug)

The follow-up tests will be done every three months. I expect by then that my testosterone levels are close to normal at above 3 ng/ml (300 ng/dL). You should check on the units used by your laboratory to avoid confusion. Normal levels of T in males is; 2.41 – 8.27 ng/mL or 241 – 827 ng/dL or 8.4 – 28.9 nmol/L

Take care.
Baptista ;)

landcrab47 07-09-2012 01:25 PM

Re: Three Month Lupron Injection
 
Thanks Baptista for a very comprehensive answer.


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