PSA rising to 0.7 after 12 months undetectable NADIR

[jelpop]

diagnosed Sep 2017 at the age of 70, PSA 187, biopsy 12 cor all 4 + 4 = 8, stage 4 metastatic located in lungs, t1-4, L-4 and 5. started firmagon, casodex and then lupron for 14 months. PSA stayed at NADIR undetectable until Nov 14th when it changed to detectable at 0.7. ONG recommending new scans to determine course of next treatment.

What course of treatment should I consider?

[GP24]

Lung mets often respond very well to a chemo. A chemo is also beneficial for bone mets in your situation and recommended in the guidelines. You should not consider a chemo, you should get it asap.

[jelpop in reply to GP24]

Thanks GP24, Johns Hopkins is scheduling new scans, the results will determine their recommended course of treatment. Will keep an open mind on the chemo option.

[LearnAll]

Next logical step probably..is to add Abiraterone (zytiga) to Lupron OR add docetaxyl chemo to Lupron.

If your general health is good and you can tolerate docetaxyl chemo ,then can go for it.

If health is not so robust then, adding Zytiga might be a better choice.

These are just some possible ways..to get PSA back to undetectable. Discuss these options with your doctor.

[jelpop in reply to LearnAll]

Thanks LearnAll, I have been on a Lupron holiday for the last 12 months and am enjoying the QOL, will have new scans this week and then see what Dr Pienta at Johns Hopkins recommends as the new treatment plan.

[6357axbz in reply to jelpop]

Let us know what Pienta has to say

[Muffin2019 in reply to LearnAll]

Do you have to add to lupron, 2 years on Lupron, August psa 1.9, November before shot 4.1, does your psa spike before your next shot, no symptoms ?

[Tall_Allen]

Docetaxel

[jelpop in reply to Tall_Allen]

Thanks Tall_Allen

[herb1]

Hi Jelpop: All good suggestions but the first thing I would do is get the psa test repeated. Everyone makes mistekes. See?

[jelpop in reply to herb1]

I am sure they will order new blood work after before of after the new scans. If now, I will request another PSA and T draw.

Thanks

[herb1 in reply to jelpop]

Jelpop: why do you think that? Ask for a repeat PSA....it's a lot cheaper than scans!

[VictoryPC]

Lupron is the monster that leads to CRPC above 18 months.

[alephnull in reply to VictoryPC]

Been on Lupron for 6 years, not CR yet

[jelpop]

Thanks for the info VictoryPC

[CRPCMan]

I hate Lupron . I developed CRPC and it's been a rough ride.

[AlmostnoHope]

Watch the Lupron I totally agree.

[6357axbz]

Jelpop,

What was your PSA nadir value for those 14 months and what PSA variation did you see within that nadir?