I have a couple of questions for the brilliant minds on this site.
1. I will soon be going on a Lupron/Zytega/Prednisone “vacation”. My PSA has been stable now for a couple of months at .02. I still have 60% of my prostate tho because eight years ago as part of my initial treatment I had a focal cryo-procedure obliterating only 40% of my prostate where supppsedly my cancer was. My question is, Should I expect my PSA to go up somewhat during this vacation, even if my cancer is not coming back, Since I still have a prostate that should produce some PSA? What happens to people who have lupron Zytega treatment (and still have a prostate) then go on a “vacation”? Should we expect our PSA level to stay at it’s nadir until if and when the PC comes back? Or should a healthy prostate start producing PSA again as it did before the cancer ?
2. I feel pretty good and lift weights very hard 3 days a week. But my Recent bone density test showed -2.9 which I am told is Pre osteoporosis. I have no previous bone density test to compare against but I suppose the logical explanation is the 10 months of Lupron. Tall Allen showed me a link to evidence that Zometa and Celebrex together for some reason reduced prostate cancer recurrence by about 22%. They are not sure why but with relatively minor Side effects combined with the potential for Zometa to strengthen my bones, I suppose it’s a no brainer for me to start that? By the way anyone reading this with advanced prostate cancer should ask the doctor about using zometa and Celebrex. Here is that link pcnrv.blogspot.com/2017/06/...
Thanks so much in advance for your thoughts.
Schwah
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Schwah
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1. How to track progression after focal therapy is problematic. But you are on hormone therapy because you have a clear indication of progression anyway - no? PSA will go up on vacation - that's what a vacation is.
Thanks Tall Allen. Yes I did have progression 7 years after my focal treatment based upon increasing PSA (from 4 to 7) and based upon an acetate c-11 imaging test showing three very small Mets (at least dr Almeida and Ucla nuclear medicine both said “highly suspicious for mets). And yes eventually the likelihood is my disease will once again progress after I stop Zytega and lupron ( chemo was finished 6 months ago). However that progression may occur in months or some years from now. My question is if someone still has a prostate after a lupron Zytega regimen , wouldn’t you expect an increasing PSA to some new level to be produced from that prostate even before the disease was progressing? All men with prostates have PSA levels of say 3-5 even without any cancer present. So why wouldn’t someone who still had a prostate who goes off a lupron Zytega regimen go back to their normal stable- non cancer PSA level even before the cancer progressed? And then the PSA would go up from there if and when the cancer progresses? Or does the regimen permanently stop the prostate from producing its “ non cancer” PSA ? That’s my question.
I suppose my other question is part of my answer to Hirsh below. I’m going on this “vacation” because Dr Scholz says 15 to 18 months On Lupron has been shown to be the sweet spot for affectiveness. Longer or shorter periods have diminishing returns supposedly. And he says his patients with ogliometastisis (as I do) who he has do early chemo/Zytega/lupron and who drop below .1 PSA (I’m at .02) usually have relatively long remissions. Do you think I’m making a mistake going on this vacation after 15-18 months ?
That's an open issue with focal treatments. My PSA on my now healthy prostate 8 years after SBRT is 0.1 ng/ml. Nadirs below 0.5 after primary radiation are associated with lasting cures. After surgery, PSA should be ideally undetectable. But what should it be after focal therapy? It has to be situation specific, accounting for the percent of gland ablated and the amount of cancer in the gland. That is in the absence of gross metastases. But after metastases have been discovered, PSA usually climbs much higher. PSADT becomes an important indicator.
There are no studies on optimal protocols for iADT. If Scholz's experience is 15-18 months "on" is optimal - that's as good as any.
I also started now on a 90 drug holiday. I was on Lucrin. No Casodex or anything else, just my own heavy induced 2nd line treatment of herbs. My PSA was 0.08. I will do a PSA every month.
When my GP heard about it, he cracked and told me I probably bullied my oncologist into it. He infact phoned my oncologist. He answered: After Lucrin I can stay in chemical castration for months. I have decided to go back on Lucrin once the PSA climbs above 3. But I also think it is good to feed the prostate cancer cells a little bit of testesterone from time to time, otherwise they learn to feed on other stuff. Maybe I am wrong. Good luck with your drug holiday, please post your results.
One herb that I used from time to time and now again, is Quercitin. I used the capsule which is a combo of bromelain and quercitin - quercitin is better absorp that way. Why? Like Casodex, quercitin inhibits the androgen receptors and blocks testesterone to enter the cell. The bromelain is also good because it is anti-inflammatory. Dosage: above 2000 mg a day. I drink three capsules after every meal -3 x a day gives me 2400 mg a day.
And always cayenne pepper capsules. Three in the morning after oats. Three in the evening. Plus two big teaspoons of tomato poree. Capsaicin (cayenne pepper) also inhibits the AR.
My tea: I make tea of origanum. Let it steep for ten minutes. Swirl the cup and gulp everything down your throat. Carvacrol kils cancer, and it can even cross the blood brain barrier.
I eat raw parsley. About half a cup a day. You guys can google this. It does not come from grandma's cook book.
You will also find valuable information on the Livestrong website.
When you go and buy fresh beetroot, make a spinach out of the leaves and storks. It is absolute delicious. And drink soy milk (unsweetened) , lots of it.
A bunch of great choices. Be aware that there is research supporting a synergistic relationship between quercetin and curcumin. I take both. Here is one research article supporting this and you will find others at pubmed.gov in serious cancer journals.
Bioavailability with curcumin is a significant issue. Many good brands overcome poor bioavailability by manufacturing curcumin that has piperine added (black pepper) or meriva (lecithinized chemical agent). If neither are in your present supply, simply take a small piece of bread, put a tablespoon of olive oil on it, a grind some black pepper on the oil). Consume when you take the curcumin. It provides a major boost to curcumin absorption.
More info on knocking down a rising PSA an be found in the comments I presented in this post by other members of this community:
If the PSA starts climbing, I will not play with it. I will go back on Lucrin immediately. But like you, I hope to keep it in remission as long as possible.
Be very careful when going on “vacation”. My husband had psa well under control and after his 1 year vacation as psa started creeping up slowly it suddenly jumped to 235. Added xtandi to LUPRON and levels came down to 50. But damage was done as psa now risen to 1500 with bone and lymph Mets. Now on docetaxel - after 3 cycles psa slowing but not dropping yet. He definitely wishes he never went on the LUPRON vacation despite the horrible side effects.
As for bone mets: I have used the malaria tablet Coartem with great success. It is a combo of Artemether and Lumefantrine. Artemether is a first line treatment in China. Some hospitals in the US offer Artesunate for women as a follow up treatment after breast cancer. After four months on Artemether, I went for a bone scan. The black spot on the pelvis was gone. While still busy with the scan, the operator, a woman was totally baffled on what she saw on the screen and asked me what did I do.
Some of the stuff you are using is very insightful. This Coartem for bone mets is new to me. Can you please cite some sources, aside from the fact that it worked for you. Would also appreciate the dosage you are using. Your time is much appreciated.
The best is to Google: Artemether cures cancer and start reading.
There are more than 14 derivatives of Artemesinin. In an email to me, Prof Henry Lai recommended Artemether.
I wrote a small book on the use of Artemether. I don't know whether I am allowed to put my email here. It is thinuslandie@hotmail.com.
Basics. Take 4 tablets every 12 hours with a spoonful of oil. After five days, stop for two days. If you weigh more than 80 kg, you can take 8 tablets for a short period. On an empty stomach. Artemether must not bind with the iron in other food in your stomach. It is a peroxide and binds with the iron inside the cancer cell. Watch your blood pressure. Please read much more or contact me. Not difficult to find me.
Thx Roseanduwe. How low had his PSA gotten before his vacation ? How long had he been on the lupron ? Any Zytega or other meds with the lupron before the vacation? Thx so much.
His psa was under 1 while on LUPRON. After first vacation it went up to 44. Back down to 1 after resuming LUPRON. Up to 235 after second vacation. Down to 50 after adding XTANDI to LUPRON. Now out of control.
On docetaxel right now with ellegard switch from LUPRON in September. I actually haven’t heard of Zytiga here in Canada. Also preparing for LU-177 as possible next step.
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Zytega or Xtandi (hormone naive, dx June 2019) in foresight as a primer for Gallium 68 PSMA scan and LU 177 
Ok to take a Lupron Vacation?
Would anybody know if you could take CABAZITAZEL and still continue taking ZYTIGA, LUPRON and ZOMETA?
First post-ADT followup. So far so good ... but it's early
