Worried about my father

★2

In December 2017 my father had TURP . After biopsy we came to know that he has adenocarcinoma with Gleason score 2+4=6

Bone scan confirm the bone mets.

His PSA was 228 (high due to surgery)

We consult oncologist he prescribed

Zoladex +calutide for January

Zoladex+calutide for February

Then he put only him on calutide

His PSA on April 2018 is 0.978

His PSA on September is 2.5

His PSA on November is 11.3

Doctor said he has now Castration resistance prostate cancer hormone therapy not working more

He now prescribed on December

Casodex + zoladex

His PSA today 31 dec 2018 is Reduced to 9.5

Is he really Castration resistance stage ??

In Castration resistance the can PSA drop 2 points in a month?

What is the treatment at castration stage?

[Tall_Allen]

His Gleason score was NOT 2+4=6 (The numbers must be 3,4 or 5), and he would not have PSA that high with only a GS 6. Castration resistance means rising PSA while he was on Zoladex. If his PSA increased when he was only taking bicalutamide (Casodex), he is not castration resistant.

[Hidden in reply to Tall_Allen]

His Gleason score is 2+4 as the report tells . The material emits after turp was sent to lab.

As his PSA drop 2 points after 4th week of zoladex implant with casodex is good sign or bad?

Can I got your email address I wana send you all the reports

[Tall_Allen in reply to Hidden]

Pathologists do not report gleason pattern 2 since 2005. What country is he in? if the rest of the tumor was pattern 4, he would be classified as GS 4+4. I sent you my email.

[Hidden in reply to Tall_Allen]

We belong to Pakistan the lab was well reputed . I'll send biopsy report by email to you

[GP24]

A cancer with bone mets and a PSA of 228 is no Gleason 6. Maybe someone made an error and this should read 5+4.

Zoladex is a more effective drug than Casodex, so it is no surprise that the PSA value went down again after using Zoladex again.

It is also no surprise that it did rise after Zoladex was stopped. Zoladex will continue to work for several months after the last injection so the PSA value rises slowly at first.

Your father is resitant when the PSA value rises while on Zoladex.

[Hidden in reply to GP24]

228 PSA was due to TURP surgery.

We saw a patient with Gleason score 5/10 and bone Mets at doctors clinic.

Zoladex reduce PSA 11.4 to 9.5 within 4weeks is it good sign ?

What happened in castration resistance stage ? Hormone therapy does not reduce minor PSA?

[GP24 in reply to Hidden]

"228 PSA was due to TURP surgery."

A TURP cannot cause a PSA that high. This was probably caused by the bone mets.

"Zoladex reduce PSA 11.4 to 9.5 within 4weeks is it good sign ? "

As I wrote, the rise in the PSA value was caused by stopping Zoladex in February. Now it goes down again since Zoladex was started. This means your father is not resistant.

"What happened in castration resistance stage ?"

You have to take expensive drugs, called Zytiga or Xtandi.