10/18: PSA was .2, T was 12
3/19: PSA is 3.9, T is 296.
I thought high T was supposed to increase cancer, thus increase PSA. It seems to me that there should have been a higher PSA given the higher T. Any reason why PSA is as low as it is, given the T number?
The PSA is a 19X jump and the T is a 24X jump...same ball park...
Fish
Here is a bigger picture:
8/17 PSA 40.9
10.17 PSA 42.8
12/17 PSA 49.8
3/18 PSA 60.2
5/18- PSA 79.5
7/18 PSA 86.6
8/18 Lupron + Casodax
9/18 PSA 1
10/18 PSA .2, T 12
3/25 PSA 3.9, T 295
My T normally ran in the 250-350 range. But when PSA was 86.6, I didn't feel like a stud on viagra, thinking T should really be high. (I didn't check T when PSA was the highest.)
Any reason why PSA is as low as it is, given the T number?
I would guess that you don't have a large tumor burden, but also that your PSA will continue to go up if you stay off ADT. Are you planning on doing intermittent ADT? What is your PSA doubling time?
I am waiting to see what the Onc says. He is out of town now.
I don't understand - your psA went up 20-fold when your T went up. What do you think it should go up to?
I don’t know but I thought it would be higher. From radiation in 3/16 to HT in 8/18 the PSA went from 9-86.6. Sounds like this number is normal.
This just my take: PSA rising before Lupron then a month later it zoomed to 1. Three months later, your Lupron has dissipated and your as your T recovers, your PSA creeps up with it.. That just means that you are still hormone sensitive, i.e., as your T is at castrate level the cancer cells cannot grow. I suspect you will get another Lupron and your PSA will drop accordingly. One day, you will be at a state where T is low and yet PSA starts growing again. That’s the definition of castrate resistant, meaning the cancer cells can continue to grow even as T is still in castrate level. At that point you will most likely be prescribed with next generation anti-androgen such as Zytiga or Xtandi or Erleada (Casodex is first gen anti-androgen). If intermediate scans identify mets elsewhere, then chemo will probably be in order.
See what response you get from the next quarterly Lipton shot. Your PSA and T should take a nosedive.
Sounds like ADT has stopped working. Second line HT is likely next. I would get a CT pet scan to find recurrence first.
You say HT has stopped, Comdrdata says it is still working. I guess we will see after the next round of HT
arete1105, I think there is a lot of confusion since you haven't actually told us some vitals.. like what was your Gleason score, what was done when, what the results were. You're just tossing out two numbers and hoping for a reaction. I guess you got it, but I can't see it's of any use to you since no one actually knows what resulted in those 2 numbers.
I am a little lost here. If you look at the second response to my original post you will see many numbers. I am not sure what additional numbers you are looking for. Since last labs no additional treatment has been done as the Onc is not In his office- out of office for awhile.
You've never given us a real chronical of what treatments you've had. In one post you sort of pull radiation treatment you had out of a hat and tell us a bit about it - but never what radiation treatment it was. What sort of ADT are you taking? Are you still taking it? What was your original DX when the PCa was discovered? Gleason number? So far we know some PSA numbers and a few with T levels. What we don't know is what treatment you had before the numbers, or if the treatments were ongoing.
Much too confusing.
DX in 2013- PSA 3.8- numbers low so took the Watchful Waiting. By 2/1016 PSA was 10 so did SBRT in 3/2016(Psa then was 10) PSA dropped to 9 after treatment so I put off further treatment. When PSA reached 86.6, I started Lupron + Casodax (9/2018). Current Onc started Sabbatical 11/18. Now fast forward to my first response at start of thread.
After the SBRT - was the PSA down to 0.9 or 9.0? 9.0 would surprise me. Current practice generally is ADT along with radiation treatment. The ADT may be fairly long term depending on how aggressive your Gleason number is. Mine is G9. and I'm guessing 2 years minimum on Lupron, perhaps up to 30 or 36 months.
I looked at your profile - and can't recall seeing any biopsy results.. was one ever done, or was your DX based on your having mets at the time of diagnosis?
After SBRT PSA=9, Gleason 3/4, Grade 7, Tumor Stage T2a, Pos Cores- 4, Neg Cores- 10, Rad dose- 81, no hormone treat pre or post SBRT, I turned it down. Hope this helps.
OK. I was wondering on the PSA post SBRT - I would have expected to see it lower than that without ADT and MUCH lower than that if you'd had ADT. If you're still not on ADT - then a low PSA with a high T sounds like a good result. Sort of what you'd be looking to achieve. With radiation there will always be some PSA, generally below 2.0 is considered "OK" but lower is desirable. And there can be some bounces along the way.. Testosterone aids in cancer growth. When you have PCa high PSA can be caused by active cancer - if you have testosterone and low PSA that should indicate that your cancer might well be in remission or gone (hopefully.)
Hope that's clear and what you wanted to know. I'm not an MD - but that's my best understanding of that relationship.
I was told by my Onc that the PSA of 3.9 and T of 296 are normal. Have an appt end of the month to discuss the next plan.
Low PSA + high Gleason-FYI
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