What if Lupron alone is continued to be taken after 2 1/2 years of PSA readings at less than 0.1 with Lupron...10 1/2 year Prostate cancer survivor with no pain & discovery 3 years ago of small pelvic bone lesion which has been stable?
Only Lupron alone over last 6 months has shown PSA go from 0.9 to 2.4.
Have you considered Provenge?
It sounds like it's time to add Zytiga or Xtandi.
TA - Would you or wouldn't you recommend Provenge before Zytiga or Xtandi?
Provenge doesn't preclude use of Xtandi or Zytiga. I think he should consider adding the second line hormonal immediately, and while on it, get his 3 Provenge infusions.
Thank you. My MO is going to add Zytiga after I finish Provenge, but not during. My psa has gone from 0.09 to 0.47 in the last 12 months so I'm getting ready for new treatments. Value your opinion.
I think Provenge works synergistically with radiation or chemo. So if there are any mets you want zapped, or if you had multiple mets and were going to start chemo, it would be a perfect time. Otherwise, Provenge is fine any time after metastasis and castration resistance.
Bill it was my understanding that because of the need of adding prednisone to zytiga and predisone being a negative on the immune system, It is not done with provenge. That was from Dana Farber 5 or so years ago. I am not sure why casodex or nilandron is not added to Lupron/Zolodex in cases like yours or Grc Oliver, the original poster to this thread. How are you doing with provenge treatments?
Dan89
Dan - I haven't started Provenge yet, Although I have been approved by Medicare and Blue Cross when my psa hits 2.0. In the last 15 months my psa has gone from 0.07 to 0.47. In other words it's a matter of time. I want to start Zytiga when my psa is relatively low. So obviously it's get this Provenge BS out of the way when I reach the 2.0 mark.
Bill that sounds like a good plan, It sounds like you have a few good plans in place. I am not sure if psa velocity can accuratly be assessed when the psa in the decimals, so hoefully you have some good time before it gets to 2. This appears to be the way one gets to include prov. For Me I had progressive disease when prov. Was approved , I was to late to get it, and I missed xofigo too as a result of to much soft tissue. Enjoy your day , I am at our pool today. We had kids running around here all day, It was great.
Do you think I could get provenge? Almost 6 years out. PSA 31 at diagnosis, Gleason 9, stage m1, and my doubling time is 5 months. I did 3 years on Lupron then they added Xtandi for the next 3. My PSA is at .02 and my testosterone is less than 20. With these statistics aren't they bound to say, you're doing well on Lupron and Xtandi why add provenge...? I want it because I feel it may make the remission last longer. I'm now 65 and I'm on ordinary Medicare with a good supplement. I only had 3 bone mets but it was distant metastasis. I had a few slightly enlarged lymph nodes but all this is lying dormant and disappeared.
Yes, Provenge is approved for men who are metastatic and castration-resistant, which you are. Your rising PSA on Lupron is what defines you as castration resistant (which is why you were able to get Xtandi).
Good Friday Morning GrcOliver,
I have been in this battle for almost six years (please see bio for complete treatment history).
Looks like it may be time for a set of scans--Axumin PET/CT and a Bone Scan. You need to know where it is to know what treatment is best. Maybe Guardant360 liquid biopsy which requires only 2 vials of blood to look for genetic defects.
Best wishes. Never Give In.
Mark, Atlanta
Next Step - Rising PSA
Rising PSA
PSA rising
PSA is slowly rising with chemotherapy 
PSA slowly going down.
