Pupdog concern

[Pupdog]

Two years ago I started elagard and bicalutamide as I had a psa reading three years after prostate removal. Readings had been undetectable until the latest which was .06. Dr. Is not concerned. I have been under the impression that my readings should be undetectable. Am I wrong (I hope)?

[AlanMeyer]

I often wonder whether doctors are unconcerned because there's no reason for concern, or because they don't think anything should be done yet and don't want the patient to be alarmed, or because it's not happening to the doctor and therefore doesn't concern them.

It is possible that any progression of the disease will be very, very slow and take many years to reach a point where it becomes dangerous, however I think it is desirable to have a plan about what to do if the PSA continues to rise. I suggest that you change your schedule to get more frequent PSA tests - at least once every three months and maybe once a month so you can really see what's happening and how it's developing, with what speed.

I would also consider salvage radiation. Was it considered and rejected for some reason in the past? Salvage radiation is most likely to be effective when the PSA is very low, below 0.4 or even 0.2. You may not want to start radiation tomorrow, but it takes time to find a good radiation oncologist ("RO"), to get a consultation, and to schedule the treatment, so you want to start working on it several months before you expect to have it. I think you should look for an RO who is competent, experienced with salvage radiation for prostate cancer, and conscientious about doing a good job for his patients. Try to get local opinions about nearby ROs, ask for opinions on this forum and, if you live in the United States, have a look at the NCI Designated Cancer Centers: cancer.gov/research/nci-rol...

I also suggest you look at Tall_Allen's blog articles on salvage radiation. He's done a lot of research on the topic and is an expert on it. Go to his blog at: pcnrv.blogspot.com/search?q... and scan down the list of articles.

Best of luck.

Alan

[AlanMeyer in reply to AlanMeyer]

@Pupdog

Looking at Tall_Allen's post I see that you had more extensive mets than I realized. Please disregard my advice on salvage radiation. I was mistaken.

Alan

[Magnus1964]

I would go to radiation at this point.

[Tall_Allen]

Looking at your prior post, it looks like you had rising PSA following prostatectomy and salvage ADT (Eligard+bicalutamide) after you've had metastases discovered in your lymph nodes, bones, pelvis and vertebra. Is there a reasonn you haven't had more advanced hormone therapy with Zytiga or docetaxel chemotherapy. I assume you are now seeing a medical oncologist and not a surgeon?

[AlanMeyer in reply to Tall_Allen]

I don't know what I was looking at when I recommended salvage radiation. Somehow I had in mind that there was lymph node involvement but hadn't realized all the rest.

Alan

[Tall_Allen in reply to AlanMeyer]

It would be much easier if posters filled out profiles with a summary of diagnoses and treatments.

[donits]

Zytiga is not a cheap drug and there are some restrictions on this drug in some countries. For example, the medicine can only be given if the patient has metastases or is already after chemotherapy etc...

[VictoryPC]

Look for doubling time of PSA above 4ng. Do intermittent ADT and you will live your normal lifespan.

[j-o-h-n]

OK Pupdog.... now it's your turn to post regarding the above....

Also can you let us know more about yourself? Age? Location? Treatment center(s)? Doctor's name(s). All info is voluntary but it helps us help you and helps us too. Thank you....

And to quote a famous person:

"Let’s be strong together."

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/14/2019 5:45 PM EST