PSA spikes after having Diphereline injections

[RandomDude315]

Is it a common thing to have PSA spikes after Diphereline injection?

[Zetabow]

Not for me when I was taking it.

[Tall_Allen]

Yes, it is common. Diphereline is a GnRH agonist. That means it actually encourages the pituitary to send a signal to your testicles to churn out large amounts of testosterone. The increase in testosterone is temporary, lasting only a week or two. But meanwhile, PSA will temporarily increase. When the pituitary senses the testosterone increase, it sends another signal to the testicles stopping all further production of testosterone. This is called "negative feedback."

When men have known metastases, doctors prescribe bicalutamide for 1-2 weeks to prevent what can be a painful flare of metastatic growth. The bicalutamide prevents the excess testosterone from activating the cancer.

[RandomDude315 in reply to Tall_Allen]

Thanks for reply. My dad is always having PSA spikes after Diphereline, but then after a few weeks PSA gets to normal levels again. He was taking bicalutamide in the past years too, but for some reason his previous doctor canceled it. He still has a few packs left though, I wonder should he be taking them because of these spikes. He does have mets in bones and have been on Zytiga since summer. PSA is ~200, but jumps to 300+ during these flare periods. Also getting Zometa shots every ~3 weeks or so. Bones became much better than before, but phosphatase is still around 600.

[Tall_Allen in reply to RandomDude315]

If he keeps getting spikes, he isn't taking it often enough. That means it's wearing off between shots. Perhaps switch to degarelix, which doesn't cause spikes, but requires a monthly shot.

[j-o-h-n in reply to RandomDude315]

Greetings RD315,

Be more precise please:

Please tell us your Dad's bio. Age? Location? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)? Thank You!!!

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Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/10/2020 5:58PM EST