Hey all. Got another PSA test. At 6 months after radiation and ADT, my PSA was 1.08. Six months later, it’s at 4.3. Six weeks later, it’s 7.5. Got another CT and bone scan, showing 2 mets....hip bone and sacrum. Will also get the PSMA PET scan to make sure nothing was missed. Originally, I was at Gleason 9, but later downgraded to 7 (4+3). I got Lupron 6 weeks before radiation. Radiation was cyber knife, five 45 minute hits over 10 days. Did Lupron for 6 months. 8 months later, I’m still hot flashing, but not like before.
Any guesses as to where my treatment is headed? I’m thinking more ADT and radiation. Or chemo. Or whatever. Not thrilled about having to play whack-a-mole for the rest of my life. Thots?
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LessPaul
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That's disappointing to say the least. Sometimes those buggers escape before treatment. The one bright spot is that you've controled the disease in your prostate already.
After getting back on Lupron, you qualify for docetaxel, Zytiga, Xtandi, or Erleada. I think there is a logistical advantage to doing docetaxel first. Your options are described here:
I don't know if there is any advantage to playing whack-a-mole. It will probably bring your PSA down; but treating PSA is not the goal, delaying progression is. Systemic therapies are proven to do that.
Thanx for the insight. I see a MedOnc this week and we’ll be discussing the path forward. The biatch about this is that insurance won’t cover the pet scan, but Medicare will. I turn65 in August.
Unless you are committed to playing whack-a-mole with every last met you can find, you already have enough info to make decisions about your therapy going forward.
LessPaul: if I read your background correctly, you had 2 months Lupron before radiation, then 6 months afterward, and stopped, correct? If so, you may want to think about restarting Lupron and add Zytiga to see if you get a good response. Also, it appears you are oligometastatic (less than 3-5 mets), so you may still go for a cure with continued ADT and treating the mets with SBRT--> all questions for your Dr.
Personally, I’m a fan of whack-a-mole. Radiation kills cancer - so zap it. I like to zap the spots when they pop-up, works better in conjunction with some systemic treatments
I too did SBRT to my three mets. The psma test would confirm if there’s too many moles to whack. Either way the SBRT is not in lieu of systematic treatment (like Lupron with Zytega or chemo) but in addition to.
Dr. Bob Leibowitz -- has high success rate with late stage metastatic cancer -- some stage 4 survivors over 90 years old... on super high dose testosterone-- cancer not progressing.
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