PSA drop Testosterone jump 21days on Casodex b4 Lupron last week

[depotdoug]

Well, Last weeks excitement is over. Lupron Depot inject done now on day 8. No side effects yet. Question? Last weeks PSA and Testosterone labs surprised me.

PSA Total Ser QN 8.566 /mL (High) Date: Sep 10, 2019 11:35 a.m. EDT

PSA Total Ser QN 14.393 ng/mL (High) • Date: Aug 20, 2019 04:06 p.m. EDT

Delta Change 5.827ng/mL decrease in 21 days ______________________________________________________________________________

Testosterone Total Ser QN 294 ng/dL (Low) Date: Sep 10, 2019 11:35 a.m. EDT

Testosterone Total Ser QN • 255 ng/dL (Low) Date: Aug 20, 2019 04:06 p.m. EDT • Reference Range: 300 ng/dL - 1000 ng/dL

Delta Change 39ng/dL increase in 21 days

Why did my PSA drop 5.827ng/mL and T-levels increase 39ng/dL? Just because of 21 days of Casodex.

[Tall_Allen]

Yes. Casodex "clogs" the androgen receptor so it doesn't activate the cancer. T climbs because the androgen receptors are clogged.

[depotdoug in reply to Tall_Allen]

Great. That sounds easily understood. Now I’m wondering why my MO said stop my 30 days Casodex when it runs out?. Like today. Guess my MO a Lupron Depot Lover.

[Tall_Allen in reply to depotdoug]

Because he gave you casodex only to prevent the flare of symptoms that occurs at the start of Lupron therapy. Lupron causes a surge of testosterone, that the clogged ARs can't react to.

[mklc in reply to Tall_Allen]

Hi Allen,

I have been told that Cassodex cannot be taken for long as it might decrease the effectiveness of the 2nd generation drugs e.g. Zytiga.

Do you know if there is any truth to this?

Thank you. Mike

[Tall_Allen in reply to mklc]

it's a lightweight compared to the 2nd line hormonals - why bother?

[mklc in reply to Tall_Allen]

Good morning Allen,

My worry is the side effects of Zytiga and Predizone are worst than cassodex.

If Cassodex is working should I change to Zytiga?

Many thanks. Mike

[jmurgia in reply to mklc]

I've been on Casodex monotherapy for 5 months. Brought PSA down from 950 to 60 in 100 days. Next PSA will be in a month. Only side effect is nipple tenderness. Will stick with this as long as it works.

Joe

[Tall_Allen in reply to jmurgia]

Ask your doctor about tamoxifen 10 mg/day for the gynecomastia.

[jmurgia in reply to Tall_Allen]

I asked him about tamoxifen back when I started. He refused. Also refused prophylactic radiation. Thanks for the advice.

Joe

[Tall_Allen in reply to mklc]

It is always tough to balance survival against quality of life.

[depotdoug]

Excellent. I’m sure pleased my Med Oncologist is proactively active. Next up looking for results & explanation of my Guardant360 Liquid Biopsy blood labs. Results and research that’s my future. Can’t stop reaching for newest best answers and treatments. Thxs TallAllen

[mklc in reply to depotdoug]

Hi Doug,

Is Guardant for GERMLINE or SOMATIC?

Can you let me know how much it cost?

Thank you so much. Mike

[depotdoug in reply to mklc]

Yes I will do. I'm calling my Onc RN and staff this afternoon to inquire about the status.

The Cost well I'll find that out too. Just have to check my IU Health website patient cost estimator web page and insurance. It doesnot really matter, I want the results ASAP. Guardant360 Health site and spec sheets say its a (7) day turn-around time for results.

Doug

[mklc in reply to depotdoug]

Fast turnaround.

Best regards, Mike

[depotdoug in reply to mklc]

It is GERMLINE that is my Guardant360 liquid biopsy lab. My MO did emphatically say that the test did not did not find any genomic mutation DNA in my blood . Darn it I was hoping for success. But is not that why we do take medical test??

I’ll discus that test more in-depth Dec 10th. What in the heck is GERMLINE test category?

I go forward with hopes of my next PSA/Testosterone labs in 3 weeks. Down is good for both guys PSA and T. Right?

[depotdoug in reply to mklc]

Yes mklc,

My Guardant360 was Germline whatever that is. ? Cost from Guardant was $8,250 looks like insurance review to date. My insurance is good at taking care of claims, will see what happens for what my insurance has paid. It’s in review as of Friday.

[mklc in reply to depotdoug]

wow...that's a heavy price tag. Glad your insurance will cover.

Sincere thanks and hope you are doing well...