Is the lupron failing ?

[Muffin2019]

Started lupron in 2/17 , psa was 156.4 free wax 13.5, went through 6 dx in 2018, after dx psa was 0.6 with free under 0.1, 5/19 rose to 1.8, 8/19 went to 1.9, 11/19 went to 4.1 free o.5. Should I be alarmed , is the lupron not working as good, am I becoming castrate resistant ? The last scan in june 2019 showed bone mets healed and no new hot spots. Has anyone else had this happen to anyone else, feel good and no problems related to tge cancer. Just did another psa, came out to 3.9 and sceduled for another pet scan and bone scan. The doc mentioned adding a pill each day of zgatia or generic to the mix. Have not have any physical signs of distress and not lost weight, anybody experienced this and is this the normal route to go. I still have the side effects and still have the prostate , getting the lupron shot 2 weeks early and discuss the route forward the added pill is expensive compared to my other stuff. On medicare and said there is patient assistance available but is it based on income ? I am working part time and have 401k's ghat are over 100,000, do they count them in ?

[Nicnatno]

Hello Muffin, I was dx 3/17 and immediately did lupron and 6 rounds of chemo. Finished chemo on July 2017 and PSA came down to 0.1 from 415 and stayed there for 1 year. Feb 2019 PSA was 0.6, July was 1.1 and 3 weeks ago it was 1.6. Scans were stable. My Onc said there are microscopic cells that are becoming castrate resistant. He recommended Provenge which I am leaning towards. I met with an RO for Xofigo and asked series of questions and determined my insurance will not pay because i do not have any symptoms from the questions asked. My Onc said to not worry. He did not put me on zytiga, xtandi, casodex, etc yet. I believe he is confident that the Provenge will be a success prior to going in to 2nd line of ADT. When would that be, I don't know. He told me 3 weeks ago to not worry. I continue to receive lupron every 12 weeks. Did your Onc recommended Provenge?

Nick

[Muffin2019 in reply to Nicnatno]

I am waiting for the oc to reply on the message as what his thoughts are, I have no symtoms, what you suggested he may use but it is expensive and would need insurance to cover with deductable. My scan in june of this year was good, showed healing, the only change is I was taking aleve for inflammation after carpal tunnel all summer.

[Muffin2019 in reply to Nicnatno]

Not yet, he is doing a check on the psa in December and go from there just rove the nuts and lose 90 percent of the t.

[Tall_Allen]

Yes, castration resistance is beginning to set in, but no, you should not be alarmed. Instead, look at this as an opportunity to qualify for a host of therapies, approved and experimental, that you otherwise not qualify for. The approved therapies are: Provenge, docetaxel, Xofigo,Zytiga, and Xtandi. Radiopharmaceuticals, immunotherapies, and growth factor inhibitors in clinical trials. A few genomic-based therapies if you have any of the rare mutations that can be found with a biopsy.

[Muffin2019 in reply to Tall_Allen]

The OC called and said that at the end of the 3 month shot the psa goes up then goes down after the next shot. Having them check the psa in one month and go from there, possible scan just to check. I did notice that the hot flashes subsided during the last couple of weeks before the next shot, now back to around 10 a day.

[CRPCMan]

Lupron usually works only up to 18 months. That is why I go with the docs that use intermittent ADT therapy with great long term results.

[Muffin2019 in reply to CRPCMan]

They do not tell you that, will suggest that to the oc. How long have you been doing that snd how does it work and why does it work that well, thank you for your help.

[Muffin2019 in reply to CRPCMan]

Going to ask him about that, according to a few sites it goes for longer until it fails then they will add to it with other drugs. Easier to be de nutted , would not have to take all the drugs, pharmacitical business would lose the money.

[CWif]

My husband has been on Lupron shots intermittently since 2016. He had prostate surgery in 2003 and PSA was monitored regularly since. In 2019 scans show 2 enlarged lymph nodes, but no other cancer. When he started Lupron his PSA was 4.2. in January 2019 PSA was 5.0; May 2019 it was 28.9; and Dec 2019 it was 39.7. Dr then added Xtandi to the Lupron shot. He started taking Xtandi January 1. It is very expensive, but pharmacist at oncologist facility found a foundation that lowered the copay significantly.

[Muffin2019]

Thank you, I am seeing the dr tomorrow, zgatia is also a option or the generic and caladex is cheaper but will discuss in depth. He may just monitor the psa, the scans were good, no new activity so it is on hold and not progressed, also started taking d3 and k2.