Is it crpc after 22 months of diagnose?

[Rafithussain]

My psa has risen from 0.08 on 4 Jan 2020 to 0.972 ng/dl on 23 Rd april 2020 with testosterone level 9..I am on bicalutamide 50 mg od frm last 22 month..psa at time of diagnosis was 111ng/dl ; Gleason score was 3+4; and was metastized to inferior iliac spine at the time of diagnosis, no new spots of Mets. At present I don't have any pain .....is it crpc as psa level has risen?

[Rafithussain]

Thank u for your valuable suggestion ..I will talk about this with my doctor

[Rafithussain in reply to Rafithussain]

Metastases was at time of diagnosis..no new spots after diagnosis have been detected

[LearnAll]

Is it true that Only Casodex 50 mg a day kept your PSA so low (0.08) for 22 months ?

Please clarify what other treatments you had.

[Rafithussain in reply to LearnAll]

I only had orchidectomy at time of daignosis since thn i have only taken calutide 50 mg od along with 12 shots of zoldronic acid 4 gm .

[Rafithussain in reply to Rafithussain]

My psa had touched 0.01 in last September

[LearnAll in reply to Rafithussain]

Thanks. That explains it...Orchiectomy has already taken away major source of testosterone..that is from testicles. Adrenal gland source which is small is still active.

So logically, if your PSA keeps creeping up..your best choice might be Abiraterone as it works on both testicles and Adrenal gland.

[Rafithussain in reply to LearnAll]

Currently My testosterone level is 9

[LearnAll in reply to Rafithussain]

Castration resistance MEANS rising PSA when your testosterone is in castrate level...and your testosterone at 9 IS in castrate range. (less than 20)

Sorry to say..but technically you are in CRPC based on numbers you are giving.

[Rafithussain in reply to LearnAll]

Will abiraterone work for me

[LearnAll in reply to Rafithussain]

Its not possible to predict with 100% certainty. But, Abiraterone is a very powerful medicine which is the only medicine which BLOCKS all sources of testosterone.

I would try it but I will also watch my blood pressure, blood sugar and let a heart doctor keep an eye on my heart. Addition of Abi might get ypour T to close to zero.

Talk to your doctor about Abi.

[Rafithussain in reply to LearnAll]

My doctor was saying me today to stop calutide for some period..but he wants me to recheck my psa from another lab ..so let see what he says..

[LearnAll in reply to Rafithussain]

thats a good suggestion.. by your Doc.Inmany people stopping Calutide (casodex) can drop PSA back down.

[Tall_Allen]

If the iliac metastasis occurred while you were castrated, it is certainly CRPC. If that is not a new met, maybe not yet. Try stopping the bicalutamide to see if your PSA goes down. Bicalutamide can sometimes start activating the androgen receptor.

[Rafithussain in reply to Tall_Allen]

Not new metastasis..only that spot which I had at the time of diagnosis

[Tall_Allen in reply to Rafithussain]

In that case, just try stopping bicalutamide.

[Rafithussain]

Thank u for ur opinion

[Hidden]

I pray that you are in the 20% of men who stop bicalutamide and experience a PSA drop. I wish you well.

Question Hussain. Why not chemotherapy to kill your met and micro-metastatic cells in your vascular and lymphatic system before they land elsewhere?

Are you not a good candidate health wise or availability? Some people leave chemotherapy for last. Some hit early with chemotherapy. There are differing opinions among the medical field. Me? I believe in hit the cancer before the tumor burden increases and while the body is strong.

GD

[Rafithussain]

My age is 58 .. health wise I am ok...only hypertensive....my doc told me you dnt need chemotherapy at this stage....but still I will talk about this