ADT used to stop producing H-Testoterone (ng/dL)?

[kikepana]

Stage 4, 6 Mets. to the bone. July , 2013 positive biopsy Gleason score 8. Radical prostatectomy August 2013, IMRT (43) March 2014, start ADT eligard July 2014 to November 2016, since December 2016 I’m in Eligard with Zytiga and prednisone 5mg. Quality of life, so far good. But I worry that the PSA is going up very fast (April 2019, PSA- 0.92, June 2019, PSA- 1.79 and September 2019, PSA- 2.26 ). Testosterone 2.50 ng/dL. I would appreciate suggestions .

[NPfisherman]

Since you have asymptomatic PSA progression, I would consider switching your prednisone to dexamethasone---see below:

ncbi.nlm.nih.gov/pubmed/300...

and if that doesn't drive it back down again, consider adding Indomethacin to abiraterone to break resistance--

mct.aacrjournals.org/conten...

Squeeze more time out of these drugs since new ones are coming, but not here yet...

Good luck...

Don Pescado

[kikepana in reply to NPfisherman]

Since January 2019, thanks

[kikepana]

Since January 2019, thanks for the information. I will check today with my Oncologist.

[Hidden]

I would suggest doing molecular testing to determine if there are mutations driving resistance to ADT. This might help direct your treatment decisions.

I would also consider getting imaging to see if there is radiographic progression. You wouldn't want to change treatments until that happens.

[kikepana]

Bone scan January 7, 2019 not changes but Bone scan July 9, 2019 has changed severe increased tracer concentration involving the left ischium and the posterior right iliac bones. CT chest, CT ABD and PELV with cont ( organs are okay)

[Tall_Allen]

You will probably get the most benefit out of 6 infusions of docetaxel. With Provenge, if possible. After that, try Xtandi, and Xofigo. There are also many clinical trials you might qualify for.