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  • PSA after Lupron

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    Old 02-10-2020, 11:07 AM   #1
    redbelly7
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    PSA after Lupron

    Got my first post Lupron PSA (8 months from shot) and it's still undetectable at .06 (low as this hospital goes). Anyhow, I'm feeling better about all the shots, radiation, AUS, RALP....
    Hope you all keep up the good fight!
    Redbelly

     
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    Old 02-10-2020, 06:47 PM   #2
    Insanus
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    Re: PSA after Lupron

    If you have a rising PSA during ADT you are in deep doo doo.

     
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    Old 02-11-2020, 06:18 AM   #3
    IADT3since2000
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    Re: PSA after Lupron

    Quote:
    Originally Posted by redbelly7 View Post
    Got my first post Lupron PSA (8 months from shot) and it's still undetectable at .06 (low as this hospital goes). Anyhow, I'm feeling better about all the shots, radiation, AUS, RALP....
    Hope you all keep up the good fight!
    Redbelly
    That's a very good number, considering it is the lower limit. My goal was to get my initially very high (113.6) PSA down to below 0.05, based on research at the Strum/Scholz practice that showed there were substantially better outcomes if you could do that, which I eventually did, in fact getting it down to <0.01. I strongly suspect that you are now below 0.05. I think I can find that research, pretty old now, if you are interested.

    Jim

    - - - - - - - - - - - - - - - - - - - - - - - -
    Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
    Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
    Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low at <0.01; apparently cured.. Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs.

     
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    Old 02-11-2020, 06:52 AM   #4
    redbelly7
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    Re: PSA after Lupron

    Heck yea, I'm interested. When I took PSA at Emory, their lab went down to .02, but place in S. GA only goes down to .06.

     
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    Old 02-11-2020, 07:26 AM   #5
    Steve135
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    Re: PSA after Lupron

    Quote:
    Originally Posted by Insanus View Post
    If you have a rising PSA during ADT you are in deep doo doo.

    I'm not sure this a great post for newbies to read.
    PSA rise with Lupron isn't the end of the world! "deep doo doo" In fact many times the Lupron is still doing what it was ment to do, lower testosterone only. Since PCa lives on testosterone as its primary means of survival by Lowering testostorone is the goal! But many times the PCa finds means around Low T and starts growning. Many times a cancer cell will become a testostorone cell and be eaten by a PCa cell. Each time this accures all that is needed is a new drug to control the PCa cells from growing Many times the PCa has been able to grow in another location in the body. This then needs to be address with further treaments.
    Myself I went 1 year 4 months before BCR, all that was required at the time was radiation treatments of the prostate bed. Then 1 year 6 months later I had my second BCR the same drug use to keep Low T was still used but Xtandi was added, 1 month later.340 to .06 in 30 days. Then it was time to find the new cause this time cyberknife of Iliac bone and PSA has falling to .04 in 65 days. I'm just hopping there isn't a third....

    _________________
    Diag. 56 DOB 2/59 PSA 01/14 2.0 6/15 2.4
    Biopsy 6/15 5 Gleason Score 8
    RP 10/15 Path 54g 5x4.2x2.8cm 4+3=7 Tumor location quadrants Bilateral
    Extra-capsular extensions present,SV no invasion
    Vascular invasion none, PNI ,Multicentricity multifocal
    Margins NP lN's 5 neg pT3a,N0
    PSA 10/16 0.1 1yr 02/7/17 0.4 02/15/17 0.5
    Pet Scan 2/17 Neg PSA 03/17 0.6 Axumin trial 17.4mm BCR rt. SVB Casodex + Trelstar
    04/17 SRT (42)
    08/17 PSA 0.1 Last 6 uPSA 0.006 uPSA 2/19 0.030 2nd BCR 5/19 0.235 5/30 0.32 6/19 0.34 7/19 0.06 8/19 0.08 9/19 0.056
    10/190 0.08 11/19 0.07 12/19 0.07 1/ 27 0.06
    7/19 Trelstar, Xtandi, Zoledronic Acid
    12/19 (3) SBRT Iliac bone liasion

     
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    IADT3since2000 (02-11-2020)
    Old 02-11-2020, 08:25 AM   #6
    guitarhillbilly
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    Re: PSA after Lupron

    Quote:
    Originally Posted by Steve135 View Post
    I'm not sure this a great post for newbies to read.
    PSA rise with Lupron isn't the end of the world! "deep doo doo" In fact many times the Lupron is still doing what it was ment to do, lower testosterone only. Since PCa lives on testosterone as its primary means of survival by Lowering testostorone is the goal! But many times the PCa finds means around Low T and starts growning. Many times a cancer cell will become a testostorone cell and be eaten by a PCa cell. Each time this accures all that is needed is a new drug to control the PCa cells from growing Many times the PCa has been able to grow in another location in the body. This then needs to be address with further treaments.
    Myself I went 1 year 4 months before BCR, all that was required at the time was radiation treatments of the prostate bed. Then 1 year 6 months later I had my second BCR the same drug use to keep Low T was still used but Xtandi was added, 1 month later.340 to .06 in 30 days. Then it was time to find the new cause this time cyberknife of Iliac bone and PSA has falling to .04 in 65 days. I'm just hopping there isn't a third....

    _________________
    Diag. 56 DOB 2/59 PSA 01/14 2.0 6/15 2.4
    Biopsy 6/15 5 Gleason Score 8
    RP 10/15 Path 54g 5x4.2x2.8cm 4+3=7 Tumor location quadrants Bilateral
    Extra-capsular extensions present,SV no invasion
    Vascular invasion none, PNI ,Multicentricity multifocal
    Margins NP lN's 5 neg pT3a,N0
    PSA 10/16 0.1 1yr 02/7/17 0.4 02/15/17 0.5
    Pet Scan 2/17 Neg PSA 03/17 0.6 Axumin trial 17.4mm BCR rt. SVB Casodex + Trelstar
    04/17 SRT (42)
    08/17 PSA 0.1 Last 6 uPSA 0.006 uPSA 2/19 0.030 2nd BCR 5/19 0.235 5/30 0.32 6/19 0.34 7/19 0.06 8/19 0.08 9/19 0.056
    10/190 0.08 11/19 0.07 12/19 0.07 1/ 27 0.06
    7/19 Trelstar, Xtandi, Zoledronic Acid
    12/19 (3) SBRT Iliac bone liasion
    Thank You for posting this. The reality is once we have PCa [especially High risk disease] we are a ticking time bomb from now on. It may go into remission for years but can rear up its ugly head at anytime or location.

    My UR reminded me of the fact we can have"successful treatment" of the PCa in the prostate and it still shows up somewhere else later.

    Basically the same things that caused it initially can also cause it to reappear even if we get rid of the prostate.

    A harsh reality.

    P.S. I hope your recent treatments have been completely successful.

     
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    Old 02-11-2020, 10:13 AM   #7
    IADT3since2000
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    Re: PSA after Lupron

    Quote:
    Originally Posted by redbelly7 View Post
    Heck yea, I'm interested. When I took PSA at Emory, their lab went down to .02, but place in S. GA only goes down to .06.
    Here is the link to an abstract of the study: https://pubmed.ncbi.nlm.nih.gov/17905106 (Urology, 70 (3), 506-10
    Sep 2007 "Prostate-cancer-specific Survival and Clinical Progression-Free Survival in Men With Prostate Cancer Treated Intermittently With Testosterone-Inactivating Pharmaceuticals") "Testosterone Inactivating Pharmaceuticals" is the somewhat awkward term lead author and expert medical oncologist Mark Sholz, MD, likes to use for Androgen Deprivation Therapy (ADT). The journal Urology is a major, highly respected, peer-reviewed journal. The finding, in this practice, is especially significant because they treat many men with advanced cancer, have long advocated nutrition and lifestyle tactics in support of medical treatments, and do extensive monitoring of their patients (many kinds of tests and scans), which gives them a lot of reality-checking feedback.

    Note the publication date: 2007. That was right about the time that much more powerful imaging for prostate cancer was coming onto the scene. It was also a few years before the slew of new drugs for advanced prostate cancer opened up. I'm thinking that, while that nadir of 0.05 or higher while on ADT is still quite significant, men in that group today would probably do considerably better. But it's good not to have to be concerned about that.

    Jim

    - - - - - - - - - - - - - - - - - - - - - - - -
    Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
    Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
    Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low at <0.01; apparently cured.. Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs.

     
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