what will be next for me

[LastMohikan]

I am 58 years old from Turkey.

ı wonder what will be the next for me, I need your experiences and assistances. My prostate cancer story as follows:

May-2017, psa was 6.45, I had PC and July-2017 had surgery by robotic type. Patalogy result Gleason scour 4+3 and tarsier pattern was 5, pT3b,N0M0.

Psa was 0.05, than raised to 0.22 at Nov-2018 than I had RT with 35 days without HT, Psa level has gone to 0.03.

My Psa is started to raise and lastly it was 0.364 in January-2021. Getting PSMA-GA68 test, the result showed 1 metastatic point in the left bone of 4.th costa lateral.

I was very unhappy that hearing cancer in my bond in a short time with that small PSA values.

My oncologist applied 3 days SBRT on the cancer point urgently. after than used Casodex pill 1 week after than I had Lucrin depot 11.25mg 3 monthly .

I will have test at 22April-2021 to see my PSA level and effect of my first HT application.

thanks..

[LearnAll]

You are already on right treatment path. You do not need anything at this time other than keep checking PSA and ALP every month in my opinion.

[LastMohikan in reply to LearnAll]

thanks a lot for your reply. probably I will have Lucrin injection each 3 month for a 2year but I am not sure , my dr will say to me in April.

[Bdale in reply to LearnAll]

What is ALP?

[NOCanceros in reply to Bdale]

ALP blod test search in Google.To be sure that the cancer is not in skeleton(Bones)

[Bdale in reply to NOCanceros]

Thanks, my MOhas never even talked about that

[Magnus1964]

Stay on the casodex. If it begins to fail there are other ADT drugs that you can move to.

[Tall_Allen]

If the Lucrin is intolerable, you can have a vacation, but I think you should stick with it other than that.

[GP24]

LastMohican,

do you read Karl May? Regarding your ADT: this study reports that six months of ADT after radiation is sufficient:

thelancet.com/journals/lano...

[Justfor_ in reply to GP24]

"...(PSA) concentration increased from 0·1 ng/mL to between 0·2 ng/mL and 2·0 ng/mL after radical prostatectomy..."

We know now that such "studies", not taking into account the pre-sRT PSA, are grossly misleading.

The same happened with RTOG 9601 when someone re-run the numbers taking into consideration pre-sRT PSA.

medpagetoday.com/meetingcov...

And of course there are other 3 later studies that say the same: At the lower end of pre-sRT PSA, ADT doesn't help at all, but inversely it can shorten OS by promoting CV incidents.

[GP24 in reply to Justfor_]

I agree that you do not need adjuvant ADT in case of low risk PCa. However, my thought was: LastMohican already got a three months shot of Lucrin. So he could mention this phase III trial to his doctor now and ask him to terminate the ADT after six months.

I would put LastMohican into the lower end of the high risk group, 4+3, T3b and a bone met. Therefore six months of ADT seem reasonable.

[Horse12888 in reply to GP24]

My reading of the report shows that ADT helps progression-free survival significantly, but doesn't answer the question of duration. Did I miss something?

6 months seems to be the recommendation for all but high-risk, locally advanced and metastatic PCa, but I didn't see that confirmed here.

[GP24 in reply to Horse12888]

The study mention two three-months injections:

"short-term androgen suppression (subcutaneous injection of 10·8 mg goserelin on the first day of irradiation and 3 months later)"

This were the patients included in the study:

Carrie-patients included

[Boywonder56]

I think 3mos. Lupron is 22.5.....might want to ck..good luck

[doc1947g in reply to Boywonder56]

It is.I got two of them from 2020/05/31 + 2020/08/24 to last until 2020/11/16.

[Hidden]

Welcome LastMohikan ! I’m a kid from the 60’ s like you. I’m 59 .. I started at 53 .. no man knows the future . It’s most important to live for today , in the present . We have no guarantees .Most of us will suffer the side effects from chemical castration. Some more than others . Please try to save your bones and heart from depletion .. weight bearing exercise can help . Get some cardio in every day . Even with low t and low energy you must push through those barriers .

[MateoBeach]

Looks like your treatment was all appropriate. Sorry to learn of the bone met. I suggest seeking out Provenge treatment to add for immune support to the other therapies.

[j-o-h-n]

As my Dad who spoke Tukish used to say when he was angry "Siktire".....Keep on keeping on.....

I am a "Hamal".....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/14/2021 5:57 PM DST

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

thanks J-o-h-n, I will keep the word, which your Dad said, to my cancer :)😂 . I send all my best regards from İstanbul