Recurrent PC: My PC history as follows... - Advanced Prostate...

Advanced Prostate Cancer

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Recurrent PC

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My PC history as follows:

Quote...

At a general health check end 2010 (53 years old), a PSA of 28 was detected. After MRI, CT scan and biopsy, cancer in prostate was detected with Gleason score of 8. I had hormone therapy with Casodex 150, followed by Radiation treatment for a 7 week period from March to August 2011.

After treatment, my PSA fell to a level around 1, and was constant at a level between 0.5 and 1.5 up to 2018.

At a blood test in Feb 2019, it had suddenly increased to 4.5, and again to 8.5 in March 2019, and 8.7 in April 2019.

MRI and CT scan detected a small local tumour look-a-like in one side of prostate. After further tests, this turned out not to be a tumour.

I had another MRI done, which came out negative. I then had a very detailed Biopsy done, 24 samples, and all came out negative?

I had a bone scan done, and this one also came out negative?

Could it be prostatitis instead? I completed 6 weeks on antibiotics.

I had a blood test done end of May, and this had dropped from 8.75 to 7.9, so the week, after completion of the antibiotics, I was hoping for a "positive" blood test. The result just came back with an increase to 12.75!?

Had another PSA check a month later, which came back at 12.5, i.e. no change.

So I started a 150 mg + 10 mg tamoxifen a day therapy. This has been going well so far, without any notable side effects.

I obviously hope this will keep possible PC at lymph notes at rest. I was scheduled to have a new PSA test app. 2 months into the treatment.

The blood test was done last week, and came out with a PSA of 1.65, so it looks like Casodex has its desired effect.

I have no idea how long I should continue the treatment? Initially, I have Casodex and tamoxifen for 3 months. Could it be an intermittent treatment, e.g. 3 months treatment, then wait and see with regular PSA check, or?

I agreed with my doctor to continue with Casodex 150 and tamoxifen 10 mg for another 3 months.

If PSA stayed low by then, I will be off the treatment, but with monitoring of the PSA level, say every 3 months.

At a blood test in February, 2020, my PSA had dropped further to 1.08.

I finished another 3 months on Casodex 150 and tamoxifen 10 beginning of March, 2020, and beginning of June 2020, i.e. after a 3 months break from Casodex, I had a new blood test done. The result was a PSA increase from the 1.08 to 3.86.

I am going to see my doctor this coming week. I would be tempted to try Casodex 50 (instead of 150), to see if this could bring my PSA down to a more reasonable level, say around 1.

My reason for the Casodex 50 instead of Casodex 150 would obviously be to take a less stronger therapy, and the “fall-back” plan would be Casodex 150, if the Casodex 50 cannot do the job.

Basically, I expect I will not be able to get rid of PC, and I will have to live with it for the rest of my many days and years. I am hoping this can be done through a treatment with least possible side effect.

I would appreciate your comments and recommendations.

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9 Replies
Tall_Allen profile image
Tall_Allen

You never had an Axumin PET/CT? While you are off Casodex may be an ideal time to get one.

PCPatient profile image
PCPatient in reply to Tall_Allen

Hi Tall_Allen,

Obviously, if I could have a scan done that could detect the location of my cancer cells, this could be the basis for a more targeted treatment.

I will discuss and check the options for a Axumin PET/CT scan with my doctor.

Magnus1964 profile image
Magnus1964

I am not a fan of intermittent ADT treatment. I would stay with 150mg casodex and tamoxifen. Milk it for all its worth.

TheTopBanana profile image
TheTopBanana in reply to Magnus1964

How come? Too aggressive side effects?

PCPatient profile image
PCPatient in reply to TheTopBanana

Hi bluecatdog,

I have not had too aggressive side effects with Casodex 150. But if Cadodex 50 can do the job for a period, I can step up to Cadodex 150 later if necessary.

Magnus1964 profile image
Magnus1964

If you go to 50mg casodex would you stop the tamoxifen?

PCPatient profile image
PCPatient in reply to Magnus1964

Hi Magnus,

I am not sure whether I would stop tamoxifen. I guess I mainly get these to minimize breast tension from Casodex 150. I would assume these would be less by Casodex 50, but I am not sure. I will discuss this with my doctor.

I am obviously not sure if Casodex 50 can bring my PSA down to a level around 1, but if not, I will go back to Casodex 150, which, until now, has proven it works.

Magnus1964 profile image
Magnus1964 in reply to PCPatient

Good luck to you my friend.

First, understand that I am not critical of your treatment path. However, it has curiosity in my mind. You mentioned saving the arsenal and maybe that answers my curiosity....... with a Gleason 8, you surely have systemic disease; it’s just at bay and for ten years. That is good.

You might enter into a discussion on micro-metastasis with your pro. It could lead into another decision making process.

I wish you the best.

Gourd Dancer

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