Hadi1954

[Hadi1954]

I am 63 years old. in Feb 2014, I was diagnosed with Prostate Cancer, Gleason Score 4+3 and preneural invasion. PSA was 4.18 . I had Radical Prostectomy in June 2014, . Pathological report showed all leanph nodes and seminal vesicles were intact. 50 days after surgery PSA detected 0.01 then it went up to 0.04, 0.14 and 0.24 and finally to 0.305 on Sep 20 2015, MRI showed a new tumor in prostate bed with dimension 10 *18 mm. an a suspected leanph node with 14 mm enlargement in mezzo rectum, both my Urologist and Oncologist recommended Radiation Therapy. My urologist believed that the leanph node is not involved, but my Oncologist told me that could not take risk and started aggressive radiation in 35 session with 3D Conformal Technic to pelvis on Dec 2015. 3 month after finishing treatment course, MRI and MRS was was taken from Pelvis and Abdomen distinguished that the tumor disappeared and the leanph nodes showed normal appearance and all organ were intact. but PSA rises to 1.03 in spite of successful Radiotherapy, with showed there is still something wrong. my Oncologist Started four month ADT in May 2016 with Eligard and then switched to 10.8 Zoladex in every 3 monthes the PSA dropped gradually to 0.036 in March 2017. after that the PSA trend reversed to.05, 0.067 and now is 0.77 so I went again for MRI that showed normal condition in Pelvis and abdomen. I had not any side effect with Radiation Therapy but my blood sugar increased to 212 and my blood pressure also increased after ADT, but now both are under control.

I had my normal life and activity in spite of little tiredness.but it seems that castration resistance is performed and my Oncologist now thinking about add Casodex to my treatment plan.

I appreciate to get advises from any of this community to fight with this brutal disease and win.

[gusgold]

Rise of PSA to .77 on ADT means you have crPCa...ADT + Zytiga better than ADT + Casodex

Gus

[BigRich in reply to gusgold]

Gus,

I agree, that Zytiga with Lupron is better then Casodex with Lupron. However, if his testosterone is below 20; then while on Lupron if his PSA increases does that mean the only reason this could happen is if he is CRPC?

Rich

[Hadi1954 in reply to BigRich]

BigRich

thanks for your comment,

My oncologist wants to stop PSA rising, in the last Lab report , Testosterone also started rising with PSA, what does it mean, if adrenal gland started to produce more testosterone, then it means that casodex as CYP 17A inhibitor could be the best choice.

[Hadi1954 in reply to Hadi1954]

sorry BigRich,

Zytiga is CYP17A inhibitor not casodex

[Lombardi24 in reply to Hadi1954]

Lupron as well. Shouldn't they have started Lupron from the get go? That and chemo (docetaxel) now while things are still in early stage and localized.

[JoelT]

You said that your T level was rising with PSA, but you did not say what is your T level. Are you castrate? If you are not castrate then ask about using Firmagon before you move on and assume that you are castrate resistant.

Joel

[Hadi1954 in reply to JoelT]

Hi Joe

Yes, I'm castrate. this is some data about my T & PSA level

DEC 01 2016 T 0.100 ng/ml PSA 0.059

Mar 01/2017 T 0.063 PSA 0.034

Jun 01/2017 T < 0.025 PSA 0.050

Oct 01/2017 T 0.068 PSA 0.077

as you see my PSA level seems not in critical value but please be aware that my PSA was 3.42 before Radical Prostectomy.

[cfrees1]

You and I are in a similar place. My PSA rose to 1.89 after RP and radiation, and on Lupron for about 18 months from a post RP level of 0.05. So my oncologist put me on Casodex six weeks ago. In his view, the combo treatment might not be effective for long (if Lupron failed quickly, so will Casodex in his experience) but why not get as much out of is as we can. My PSA this week was down to 0.8 and we hope it will do down even further. So, yes, there are more effective treatments out there now, but I'm saving that arrow in my quiver for now. Good luck on Casodex, I didn't have any new side effects from it at all and it's a simple pill I take at night.

[gusgold]

First you say your PSA is .77 then you state .077..if you want advice get your act together

[Hadi1954]

Hello gusgold

It was mistyping. 0.077 is correct. Until now I learned a lot, let’s exchange idea and information

[Hadi1954]

yes, it could be. but the other scenario is far distance metastases. my oncologist afraid of stopping ADT,in order to let the tumor grows until detectable in imaging . and prefer to keep PSA as low as possible.

[Sisira]

Could you please specify the unit measurement of this 20 for the Estradiol test?

Sisira

[Sisira in reply to Sisira]

Above question is for Nalakrats.

Sisira

[Sisira]

Mr.Nalakrats,

I have more confusion now about the way you have expressed the unit measurement. Picograms per Millimeter. Millimeter is a linear unit! and also in 'pg/mg' you have given 'mg' should read as milligrams. Our labs some times give different units and also we are not Experts like you. Anyway thank you for your response.

Sisira

[Sisira]

I didn't ask anything about T. What do you mean by your 'pg/mg' for the Estradiol test? Is it correct?

Sisira

[Sisira]

Mr.Nalakrats,

When you are requested to make a simple clarification regarding the unit measurement of a blood test which you have incorrectly stated, you are trying to teach us molecular theories! Please don't try to throw your ' kitchen-sink' at everything!

Yes, I am done with your shoddy replies.

Sisira

[Sisira]

Self esteem is not Self Importance! Bullshit, fully ignored.

Sisira