ADT Vacation - update 2

[fireandice123]

In my last update I wrote that I’d be getting a PSMA scan assuming my insurance company cooperated. Well my insurance company hasn’t been very cooperative. The didn’t approve the PSMA. They did say they wanted a CT scan first before they’d approve the PSMA. My MO didn’t expect the CT scan to show much that is useful but we went along and I had a CT scan last week.

As expected the CT scan didn’t show much. My MO said that it neither showed definitively that my cancer had progressed nor that it hadn’t progressed. Hence the need for the PSMA. I guess the good thing is that I don’t have any big new mets that the CT scan could see. The question still is do I have any new mets that are too small for the CT scan to pick up? So a PSMA scan is again scheduled for early May. Hopefully, the insurance company keeps their word and approves it.

Oh, the CT scan also showed I have gallstones. For some reason I find that very disturbing. Only old farts get gallstones. I can’t really be an old fart, can I?

[Tall_Allen]

What will you do if the PET/CT scan shows metastases?

[fireandice123 in reply to Tall_Allen]

Good question. It’ll be a very sad day but most likely I’ll go back on ADT to start. Don’t know after that. Do you have any thoughts?

[Tall_Allen in reply to fireandice123]

I don't know how many bone metastases showed up originally. If total is less than 4, RT to the prostate may be beneficial. That would be combined with ADT+Zytiga.

[fireandice123 in reply to Tall_Allen]

Another round of RT? I had RT to my prostate and pelvic bone mets a little over 2 years ago and then went back on Lupron.

[Tall_Allen in reply to fireandice123]

Sorry, I missed that you had prostate RT.

[fireandice123 in reply to Tall_Allen]

I do have a question about doubling up on ADT, like Lupron and Zytiga at the same time. I get that it may be better to double up but at some point I'll most likely become castrate resistant and have to move on another treatment. Would that point come sooner if I double up ADT and would I get a longer castrate sensitive period by going with Lupron until it is no longer effective and then move on to Zytiga?

[Tall_Allen in reply to fireandice123]

The opposite occurs. Men who are hormone sensitive enjoy a longer time to castration resistance if they take Zytiga.

[fireandice123]

No worries. So I add Zytiga into my ADT mix. Thanks for the advice.

[Hidden]

Gallstones? Ouch! Damed insurance! Make em pay! I felt young at 52 prior to APC tagging me . 7 yrs later im a card carrying “ol guy” memeber with all that’s attached to it . Whoohoo. ! Lucky to be here! 🏜✌️

[SteveTheJ]

Not true. I know some people my age, 60 and under, who had gallstones removed.

[Hidden]

What did your Testosterone go up to in the holiday? Did the PSA rise mirror it?

[fireandice123 in reply to Hidden]

My last testosterone reading a couple of months ago was 576.

I just noticed they have been mentioned on all my preceding CT scans going back to 2017. I never caught that and my docs didn’t mention them, at least I don’t remember them saying anything but they could have They’re just mentioned on one line of the report. They don’t bother me at all.

[MateoBeach]

Dagnabit! It’s one darn thing after another for us aging OFs. Gall stones are like bees, if they are not bothering you then don’t bother them.

[fireandice123 in reply to MateoBeach]

Yeah, fortunately they don’t bother me at all.

[j-o-h-n]

At 63 you ain't no spring chicken....And you've got some gall saying stones are for old people....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/08/2022 7:55 PM DST

[slpdvmmd]

No money saved by insurance, unnecessary radiation exposure by CT, and delay in care. Bad on the insurance industry. They should be held accountable. If PSMA PET/CT is positive have to entertain radioligand/LU177 as well. Wishing you the best.