Metabolic Panel ?

[reconjj]

Hello Friends , Im on 6 mo.Eligard . Feb. 1st I started Zytiga , 250mg with 5mg of prednisone taken on a light breakfast . Also started on Feb. 1st are 25 days of IMRT. 1 month earlier I had 1 hot lymph Node radiated with SBRT . So now how often should Albumin , Alk Phos , AST , ALT, PSA , or any other test for eg. , Heart , Bone Density etc . V.A. gave me a metabolic panel prior to ADT , all was good . . MO says just prior to next visit , which is 3 months away . I say sooner ? Thanks JJ

[Tall_Allen]

Don’t have it before 3 months. Your PSA increases right after the radiation. It is not meaningful.

[reconjj in reply to Tall_Allen]

Thanks Allen , what about bone density ? Heart ?

[Tall_Allen in reply to reconjj]

You are just on short term adt. Unless you have preexisting conditions, no need to monitor those.

[GoBucks]

Zytiga can affect your liver. I have a BMP every month.

[Hidden]

The VA standard of care is every 3 months for blood work (CBC, metabolic panel & PSA). However when starting Zytiga, your blood work should be followed closely for several weeks. That's what the VA did with me. If you really want blood work done sooner than 3 months, ask your MO for a standing blood work order that allows you to go in every 45 days, never seems to a problem. If you want a Dexa scan to measure your bone density, ask your PCP for a referral. Key to the VA, your PCP manages all your care, don't piss them off.

[LearnAll]

CBC, CMP, PSA every month in first year. Dexa scan every 6 months.

[tango65]

The DEXA scan is usually done every 2 years.

[noahware]

Knowing how quickly the PSA responds is nice, but not essential. However, I agree with Nameless999 and GoBucks that the new med (Zytiga) merits blood work well in advance of three months. With many meds (Casodex, etc) there are rare events like liver toxicity that are best caught early. I would check ALT, AST and ALP within a month or so. (Keep an eye on BP too, as hypertension is possible.)

[LearnAll]

Guidelines are based on how much Insurance companies are willing to spend on your care. These guidelines are arbitrary. You are not the center of their universe. But you are center of Universe for yourself and your loved ones.Zytiga or even Bicalutamide can cause severe liver damage in some men. So there is lot at stake. These meds are not candies.. they have potential severe side effects in many men.

I was told by my Insurance company in past that they allow PSA only every 12 months.. Ridiculous ! I pay out of pocket and check PSA, CBC and CMP every months or sometimes every 2 weeks. To me once a month, CBC,CMP and PSA seem very good monitoring.

One must get DEXA scan before starting ADT (to know baseline) and then, every 6 months to see how bone density is changing. Dexa Scan is done every 2 years again to limit expenses by payers. In my area, Dexa Scan costs $60 in private imaging centers.

[London441]

Everyone has an opinion, as you can see, and so do I. My take is that one size does not fit all, not by a long shot.

The most important question is: How is his overall health? If his numbers are good going in and if his diet, strength and cardiovascular fitness are also good, he doesn’t need any of that for a measly 6 month course of ADT. You can run all that when he’s done.

On the other hand, if he has high BP, CV issues, is overweight and/or sedentary, pre diabetic or diabetic etc then that’s different. Then you want to monitor everything.

[Kittenlover50]

Most are ok every 3 mo. They did have monthly liver enzymes though on the zytiga, especially in the beginning. After about 6 mo went to every 3 mo.

[CharlieBC]

I was on 1000mg Zytiga, and the Oncologist checked monthly for liver enzymes. Sure enough, after a couple of months my AST and ALT shot up (11 times the upper range). Took a break to get the numbers down, then cut the dose in half. Same result, had to switch to Xtandi. 3 months seems long before checking, even at the lower dose.