First, a short background of my dad (72 years old) was diagnosed with G9 metastatic prostate cancer in early 2020, first step was radiation and then ADT + Zytiga , PSA dropped to 0.01 and OC recommended a vacation! 5 months later, in early March his PSA level increased to 0.04 !
Today, I received his latest full test result and need your help to understand what’s going on with him, please!
His FAI , FSH, and LH are very high and the Google tells me all are indicators of a shorter time to development of CRPC and worse prognosis!
As of 6/21, his FSH level was 5.9 and now is around 73 ! his LH was 0.5 and now 42!
Or his TES was around 7 in 8/21 and now around 207 !
How do you interpret these results? Is he going to be CRPC? Was taking vacation wrong ? What should we do right now ?
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Spring_moon
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I am not a fan of ADT vacations. They only give new cancer cell lines a chance to find a work around to the treatment. My advice would be to go back on zytiga. If zytiga fails, move onto xtandi and stay on it.
He is castrate resistant if he is using ADT and his PSA value rises above 2.0 ng/ml (in short). So with 0.04 ng/ml he is not resistant. If he takes a vacation, the PSA will always rise again. Usually the doctor has agreed with the patient at the beginning of the vacation at what PSA level the ADT shall start again.
Hi Tall_Allen, thanks for responding, please tell me why all of sudden his LH and FSH got so high??? FSH from 6 to 73 , more than 10 times normal range and LH from 0.5 to 42, 6 times normal range ? What are they indicating?
His Tes was 7 (8/21) then 70 then 227 and then 207 (now) , And it is marked Low!
I had lymphnode involvement and stopped ADT in Oct 2021. Not a vacation for me but seeing if my treatment with "curative intent" was successful. I don't know if this is an option with bone metastes but if it is it might be what you father is experiencing now. I just had my most recent PSA and it went from <.04 in December to .09. My was back slightly above baseline in Dec but I had no tests for LH, FAI or FSH that I am aware of. It sounds like I am in a similar position as your father though I am younger. He has his prostate still so it will take a little time to determine his doubling time. Also I have read radiation can cause bounces in PSA up to 2 years after. I think we will have to give it a few more months to see what happens but I will have to see what my MO thinks in the next day or 2. Is your father testing is PSA quarterly or monthly?
Here's the info I ref above, see "After radiation therapy"
Hi. Has anyone looked into BAT (bipolar androgen therapy)? I have been reading a lot about it lately. I know that it is just in clinical trials at this point, but it looks promising. From my understanding it presents the possibility of being able to continue ADT indefinitely without going into castrate resistance. I also know of a fellow who is employing the BAT model with the help of his MD and oncologist and is having great success with it now for over 3 years.
Hi. His name is Russ Hollyer. I met him on the Facebook page called “Prostate Cancer: Latest Research and Developments” He’s a great guy and I’m so impressed with the info/research that he has done. He has told me plainly that even his MD and MO are not signing on to what he is doing because it’s not “standard of care” but they are acknowledging that it’s working, and therefore are basically saying…keep going. That being said, I’ll give you his Doctors names etc. He also has a Journal/ebook that outlines his prostate cancer journey so far and has all of the doctors names, and info on BAT in it. I will try to send it to you also. I’m a technical zero so I’m not sure that I know how to do that from this format. I’ll try, but it might be easier if I had your email. You can get his ebook also by joining that Facebook group that I mentioned up above and looking up some of the threads (he posted the ebook in one of the threads and you can click on it to download it) or just message him and ask him to send it to you. His Medical oncologist is Dr. Amber Flaherty arizonaoncology.com in Phoenix, Arizona. His Primary Care physician is Dr. Frank Cibulka honorhealth.com in Phoenix, Arizona. He also highly recommends a Dr. James Spurgeon at optimal medical health.com (he’s a NMD but I don’t know what that is). Honestly, I’m not trying to glorify Russ Hollyer, but It would be well worth anyone’s time to get that journal and read it. I printed that thing out and I reference it all of the time. Hope that helps you my friend. Message me anytime.
Would you please be kind enough to tell us his bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
All info is voluntary, but it helps us help him and helps us too. When you respond, copy and paste it in his/your home page for his/your use and for other members’ reference.
Hi John, I’m such a slow typist, but I’ll try to post the pertinent info. I think that it would be best though, and more informative for folks to just read his journal since it has all of his Bio, age, treatments, scores, medications etc. in black and white already typed out. Below is the link to his Journal/ebook on google drive. He’s about my age (61) had Radical Prostectomy with a Gleason 9. He’s been on ADT for at least 3 years now.
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.01 and two spots on psma test. 
ADT Vacation?
drug vacation 
My brother has advanced prostate cancer
First PSA Three Months After Starting ADT Vacation
