What is PSA NADIR for ADT treatment?

[Pcnmyy]

Hello friends,

I am lupron and Erleada for the last 6 months. My last PSA test result is stated as <0.1. Is this PSA Nadir for my case? Thanks.

[Tall_Allen]

That is a great result - congratulations! Nadir means the lowest point reached and the "<" means it was undetectable.

[Pcnmyy in reply to Tall_Allen]

Thank you so muchTA for the quick response. Does this mean that all cancer cells are dead or just under control?

[Tall_Allen in reply to Pcnmyy]

Hormone therapy by itself is not a cure. Is Lupron+Erleada all you have done, or have you used radiation as well. There is nothing about your diagnosis or therapies in your profile.

[Pcnmyy in reply to Tall_Allen]

Well, I was diagnosed with Advanced Prostate Cancer Nov. 2019 after an elevated PSA (65) and a biopsy (Gleason score 9 and cancer spread to regional lymph nodes and no bone mets). The diagnosis was confirmed by bone/CT and PSMA scans.

Both my Urologist and Oncologist determined that surgery and/or radiation will not help me. Initially they put me on Eligard+Erleada then switched to Lupron+Erleada. Today I will have my 2nd Lupron shot. My last T score is <3.

I would appreciate your thoughts and

and suggestions.

Thanks

[Tall_Allen in reply to Pcnmyy]

You seem to be doing great with your current therapy.

[Pcnmyy in reply to Tall_Allen]

Many thanks brother.

[mperloe in reply to Pcnmyy]

Many docs are using radiation to the primary even if there are metastasis. Overall survival seems to be improved by something called the abscopal effect.

[JamesAtlanta]

Congratulations on a great response to treatment!

James

[Pcnmyy in reply to JamesAtlanta]

Thank you James. Do you know of a top Oncologist in the Atlanta area to review my treatment plan and give me a second opinion?

[LearnAll]

PSA Nadir is the lowest point PSA reaches during first 12 months of ADT. You acieved < 0.1 and that is super excellent Nadir..you are destined to live many many years more. Currently,

you have almost negligible cancer cells in your body. A few might be hiding here and there.

Based on Dr Maha Hussain's 2006 landmark research, people with less than 0.2 PSA Nadir have median survival of 6 1/2 years...note that this is median..means 50% lives more than 6 1/2 years. That study was almost 15 years ago and since then, a lot of new treatments have come.

If your Teststerone level is have very low Nadir..like less than 10...then estimated survival goes up..like 10 years or more. Time to relax and celebrate your good fortune.

[Pcnmyy in reply to LearnAll]

LearnerAll, thank you so much for the positive message and prognosis. You made my day brother.

[LearnAll in reply to Pcnmyy]

One suggestion: Eat plant based antioxidant,anti-inflammatory diet, exercise and keep BMI below 24....to maintain the amazing gains you have made. Best of luck.

[Pcnmyy in reply to LearnAll]

Great suggestions. Thank you also for the Papaya leaf suggestion. It worked and raised my blood platelets by 20K in two weeks.

[Ramp7 in reply to Pcnmyy]

Could you expand the information regarding Papaya.

[Hirsch in reply to LearnAll]

Would you clarify that last paragraph beginning with. If your testosterone. Thanks

[LearnAll in reply to Hirsch]

Just like PSA nadir...testosterone nadir also has prognostic significance. After being on ADT, various men reach to different low point of testosterone...some go as low as 5 or 10, some only reach 20, some only reach 50 and some even more than 50.

When you achieve extremely low testosterone level such as less than 10...it is a very good sign for your longer survival.

[Hirsch in reply to LearnAll]

Thanks. You are quite knowledgeable

[Magnus1964]

PSA nadir is different for everyone. You may find your PSA bouncing around by +/- .05 with each reading. This is normal. Keep an eye on trends.

Here is hoping for many years of low PSA and good health.

[Pcnmyy in reply to Magnus1964]

Magnus, thank you for your response and suggestions. The problem with my last PSA report that it does not provide a result below 0.1. I use Lapcorp. Any suggestions?

[Magnus1964 in reply to Pcnmyy]

You may have to get an order for a blood test and take it to another lab. If Lapcorp can't do tests fine than .1 that may not be fine enough.

[TJGuy in reply to Pcnmyy]

I just had a ultra sensitive PSA by Lab Corp, I requested my primary care physician to request one for me to the 0.000 level.

Lab Corp billed $122.50 for the ultra sensitive PSA total test.

They also billed $122.50 for a PSA free test.

If I were to do it again I'd only have the PSA total test performed if possible.

My experience is the personnel performing the blood draws know nothing about the different levels of the PSA testing. What my doctor requested prints out on the label to be attached to your blood sample so the lab processes it appropriately.

[doc1947g]

I am 73 y.o. with a pre-Rx PSA of 20.4, G(4+3=7) Grade 3, UIR.

VMAT-RT 3 Gy X 20 Fx and ADT for 6 months.

Now my PSA=0.03 and my T <5.7684 ng/dL or <0.2 nmol/L.

I though that the PSA=0.003 could not be counted as nadir because once the ADT effects will disappear the PSA will re bounce.

TA probably have the answer.