Should I be content with Current PSA? Or should I be asking my NO to be more proactive?

[Hohman]

I am currently receiving Lupron shots every 3 months and my results have been a PSA that is undetectable but I was diagnosed with bone Mets before this started...how am I to know if it's stopping the Mets. My MO doesn't have me on anything else? I had maybe 2 small spots...the size of a quarter..previous prostatectomy and beam radiation with rising psa..negative lymph nodes...so must have traveled through my blood. From reading all of your post I feel like I am supposed to be on ads to treatment??

[Tall_Allen]

Zytiga, when added to ADT, for metastatic hormone-sensitive prostate cancer extends survival. If you had multiple mets, Taxotere also. Read this article that explains your options:

pcnrv.blogspot.com/2017/06/...

[Hohman in reply to Tall_Allen]

Thank you for your input...i will talk with my MO about why he wouldn't try this early on...

[Litlerny]

I totally agree with Tall_Allen. I have been on Lupron and bicalutamide for 3 years, and added chemo with docetaxel last year. I’ve discussed adding Zytiga with my MO at the Mayo Clinic in Jax. He’s not opposed to it but wants to wait until my next follow up visit at the end of 2018.

I have remained pretty much totally asymptotic for over 3 years, with PSA undetectable, testosterone in single digits, and my single pelvic bone lesion has stopped lighting up the scans for over 2 years. The bone scans should be able to tell how much effect your treatments are having on your bone mets.

Best wishes to you!

[HopingForTheBest1]

Also make sure to check your alkaline phosphatase level in your blood work, which is evidence of bone disease. I have mets in the pelvis. My AP went from 248 down to 133 while on Eligard + Zytiga/Prednisone for the past 2 months.

[Hohman in reply to HopingForTheBest1]

My Alk Phos is 63...which I understand is very good?

[HopingForTheBest1 in reply to Hohman]

Yes, it is well within the normal range which runs up to 117.

[Rmanns]

When was your last bone scan? Why not check that directly first.

[Hohman in reply to Rmanns]

Last bone scan was 6 months ago before I started Lupron every 3 months. Someone said to check my Alk Phos which is 63 and I was just told on here that is pretty good. I had 2 PSA results of undetectable but after reading through here I felt like I should be pushing for more?

[Hidden]

You asked and my bias will show. I believe in aggressive treatment of metastatic prostate cancer. To my knowledge, all other standard of care treatments are palliative and you can, but not always, maintain an upward expected survival time of twenty years or so. You can check and see if the numbers have changed in the last 15 years. When I faced the possibility of aggressive treatment, life expectancy was 2-4, maybe five years. However, remarkable new drugs or silver bullets have driven that number up.

Note: the only known method of killing micro metastatic prostate cancer cells in the vascular and lymphatic systems is through chemotherapy. Oh you may stop growth, but ....

I initially entered into aggressive treatment because my MO looked me in the eye and said that he could buy me an additional five years, guaranteed. At five years, he said that I had an additional ten years. Since 2010, he said, “You have no sign of metastatic prostate cancer.” To prove the point, we stopped Lupron injections and a year later started low dose testosterone treatment. I still enjoy undetectables and a testosterone level that ranges from 350 to 650.

I have been most fortunate and my new Urologist remarked that do you really know what your Oncologist told you eight years ago? Congratulations! Very few Oncologists can tell that to a patient. We then entered into a discussion of aggressive treatment while the tumor burden is minimal and the body is still strong.

My friend, the care that you are receiving is excellent and will extend life, but is palliative in nature. My bias and experience says, go for the kill. You may just win. Or, you may not. Your biggest problem is to find a forward thinking researcher who specializes in Advanced Prostate Cancer. You will find these rare breeds at major medical schools with research facilities where in addition to teaching young doctors, they spend their time in research and clinical trials; and hopefully hold clinic for their patients. There are no guarantees that their treatment will be as favorable to what I experienced. My frame of mind was simply, what do I have to lose and and a possibility of a win.

My two cents, for what it is worth. Continue kicking the bastard.

Gourd Dancer

[HopingForTheBest1 in reply to Hidden]

Your story is very inspirational. and offers a great deal of hope to us in this forum. Did your aggressive treatment include surgery/prostatectomy?

[Hidden in reply to HopingForTheBest1]

No, my primary plan treatment was Brachytherapy and 25 sessions of IMRT. But my PSA never really came down. At 11months I had mets to L2 & T3 of my spine. It didn’t matter which primary treatment which I had. I learned the term micro-metastasis. Simply put, the little bastards were using my vascular and lymphatic systems as a super highwaylooking for a place to stop and multiply. In 2004, there was only one way to kill them. I understandt that today, there is only one way to kill them.

GD

[Debsket in reply to Hidden]

Sorry I may have missed it but what is the aggressive treatment? The one way to kill them that has worked for you?

Ds

[Debsket in reply to Hidden]

I checked back through your history and found where you recorded it.

Wishing you continued good health! Thanks for sharing your story, perspectives and determination. Inspiring!

[Hohman in reply to Hidden]

Thank you for your information..it means so much