Dad is on Lupron for the past 18 months his PSA went up I'm worried

My dad was diagnosed with PC Jan 2015 he has been on Lupron and xgeva and his PSA was low went for his monthly blood test last week and PSA was high above normal range for lab values Dr office called and said we need to draw blood and retest I'm worried is his PROSTATE CANCER getting worse I don't know how to look at this before I tell him he doesn't speak English I help him out with appointments so I'm worried myself and I don't want him to get overly worried with the holidays coming up. Any thought are welcomed. And helpful.

Thank you,


14 Replies

  • Olivia, Lupron eventually fails in most men, but the length of time can be very different. It sounds like this might have been a contaminated sample, but even if the PSA is rising, don't lose heart. There are other treatment options. I have been an advance PCa patient for nearly ten years. My PSA started rising almost immediately after surgery. We started with Zolodex (similar to Lupron), then moved on to other things when that wasn't doing enough. You may want to read up on Xtandi and Zytiga. I've been on Zytiga for two years with decent results.

    Best to you, Yost.

  • While a rising PSA is a warning sign, the doctor may want other tests, like a CT scan and bone scan before deciding what to do next. I have been on Lupron for over 2 1/2 years, and progressed to Zytiga then Xtandi for as long as they worked before my first chemo in May of last year. While the cancer continues to progress, I am fortunate to continue to feel well and remain active. Best wishes!

  • Thank u

  • Hi Olivia, God Bless you for caring for your Dad!

    I would keep using your current treatments of Lupron and xgeva and retest again in thirty days and see what the PSA is doing, stay calm and re test, if your current treatments stop working then there are other treatments ahead in your future, you are not done yet

    your doctor and you will decide what is next, me personally I am now on chemotherapy

    and that is working for me right now, my psa went from 45 to 4.9 with chemo.

    so hang in there and keep fighting , enjoy every day, life is good!


  • Thank you, God Bless you as well.

  • Hi Olivia,

    Lupron started to fail me about six months ago. I'm now on my fifth month with Zytiga. My PSA went from 29 to 1 in two months. I have no side effects at all. I'm fortunate that I had a good liver from the start. I don't know how, the way I inhale beer. But, my oncologist checks my blood monthly. Other than that, I agree with Yost.


  • Olivia,

    Yes, it is possible that his cancer is progressing, but it is also possible that it isn't progressing.

    The first goal is to establish what is actually going on in him. Lupron is designed to make him castrate, sometimes it does not get a man to castrate levels which is required to have a successful treatment. So, do have a confirmatory PSA test but also have the doctor take his testosterone level (blood test that should be made when he as the confirmatory PSA test). If the PSA is confirmed, but he is not at a castrate level then there can be additional manipulations performed to get him to a castrate level.

    You should also have the doctor add the drug Casodex (bicalutamide) which is an anti-androgen.

    I also wonder why he is currently on Xgeva. Usually we try and hold off with Xgeva until he is castrate resistant. We do this to help and delay the possible long term negative side effects that sometimes accompany Xgeva.


  • Hello Joel thank you for your response, my dad is on Xgeva because his cancer did metastisize to his bones. So the doctor said it would help his bones. We will get another blood test on the 9 of December and go from there. Thank you for responding.

  • Don't forget to have his testosterone level measured, this is important and often neglected by some docs.


  • Hi Joe, we got our second PSA blood test back and it was 3.64 it was high than 3 weeks ago so the Lupron the doctor suggested we start Provenge? But we will talk about this more on the next office visit. I wonder why he wont suggest Zytiga? Any clues to why not another injection? But Provenge? I want to do my research before our next appointment. Thanks Joe

  • Olivia,

    If he is in fact castrate resistant then Provenge is his best next step.

    First, before it is decided that he is castrate resistant make sure that his testosterone level is in fact under 20 ng/dl. If not, the problem might be that he has too much testosterone still in his body. In this case it is best to modify the drugs to get his testosterone to a castrate level.

    Also, has he been given Casodex (bicalutamide)?

    If he is castrate resistant then Provenge is his best next treatment. Provenge works best when the PSA is at very low numbers and there is minimal cancer in his body. The longer it is delayed the less effective it will be. A course of Provenge only takes one month then he could move onto Zytiga or Xtandi.

    If you want to learn more about Provenge go to the Advanced Prostate Cancer Blog ( and search Provenge.


  • Thanks Joel yes his testosterone is and has been low. I dont understand why the doctor wont try another ADT injection before the Provenge? or how much time on earth will it give us the lupron was ood for almost 2 years. This is mentally exhausting Im trying to know as much as I can beofore our Doctor visit. Thanks again

  • If in fact his PSA is going up while he is castrate then he should move on to another treatment, my personal opinion is that for him Provenge is an excellent choice. Also please be aware that It has a very low side effect profile.

    Also, you should also know that he should continue to get Lupron forever along with another treatments he will take going forward.

    I understand that seeing him progress is hard, but he is better off getting what he needs.


  • Hi Olivia, I appreciate your help with this disease. I had metastases 6 years ago and have had 72 radiations. My oncologist put me on Lupron every 3 months and Xgeva every 6 months. My PSA has been 0.00 for 6 years. I still have single cell cancer, but they can not form tumors because they can not multiply (can not subdivide). So the cells have affinity for my pelvic bones and attach inside. Then they sink into the bone and leave a small pock mark (like an acne scar on your face). Over time the bone is weakened and that is why I have Xgeva injections which is for osteoporosis to harden the bones. Now I have only have one shot of Xgeva per year. The reason the cancer cells are single cell is because Lupron tells your pituitary gland to stop making all androgens (male hormones). The cancer cells have a sensor area called the AR (Androgen Receptor) that stimulates the cell to replicate and form the double helix. So without androgens the cancer cell can not replicate very well. Unfortunately the pituitary gland may not be responsive to letting the Lupron "fool" it, and other drugs can be used. There is no "for sure" way to stop this disease, so we all keep in touch with each other for the new information available. Stay in touch and we wish your father well.