PSA rising

[Ming1828]

My husband has aggressive prostate cancer. He was diagnosed 9/20/2019. Gleason score 9. Because he is 93 he is only treated with ADT. His PSA was 100.4 when he started treatment. He had a TURP and found the cancer. My question is can he start having side effects after being on ADT for 2 years. His PSA started to rise in 4/20/21. He had a PSA of .44 and last visit was 3.35 which was 03/28/2022. He is either getting dementia fast or side effects from ADT the last month. Headache, very weak, eye problem worsening, lot of urine, forgetfulness. I am hoping they stop injections on next visit. He remains calm and never complains.

[Tall_Allen]

Why doesn't he have an orchiectomy? I think it can be done with local anesthesia.

[spencoid2 in reply to Tall_Allen]

mine was with general anesthesia which was no big deal for me? Was under for less than a half hour and supposedly with something pretty minor. however for a 93 year old guy I would find a surgeon who will use local. I did not fight my Uro over this but if I were older (67) I would have.

[Ming1828 in reply to Tall_Allen]

Will ask his Dr. Thank you for advice

[Magnus1964]

What ADT drugs has he had up to now? If he has only had one, then he should be able to move to another.

[larry_dammit]

My dad went through this himself, ADT does add to the memory loss and weakness, the treatment worked for a long time. Finally quite working with his PSA rocketing over 400. The dementia finally got him at 89.

[spencoid2 in reply to larry_dammit]

ADT can cause all sorts of mental issues. I am clear headed and my short term memory has returned. However for a considerable period of time I couldn't write computer programs, getting confused and could not remember what I had started across the room to do once I got there. After a while on ADT these symptoms cleared up and now what was I writing about???

[larry_dammit in reply to spencoid2]

I was unsure if it was the ADT ,Chemo or the Xtandi that caused my brain fog but it finally got better about 2-3 years into this war😡

[Ming1828 in reply to larry_dammit]

My husband at his age is more concerned with quality of life than living longer. He cannot walk without walker and he falls a lot. I am not in good health myself and praying I can take care of him the rest of his life. The sudden memory loss concerns me and his PSA starting to rise. I do want to know if PSADT can be calculated when only ADT is the treatment. I pray for all who has this terrible cancer.

[TJGuy]

I'm sorry anytime another man and loveones have to deal with this disease.

At 93 certainly there should be a health cost / benefit analyst considered.

These drugs and procedures are tough on much younger men, with many side effects including strength loss.

Losing strength at that age could result in falls. Losing mental capacity presents dangers as well.

They also have severe cardio vascular effects.

[Ming1828 in reply to TJGuy]

Trying to live this one day at a time. We have wonderful memories. He has his long time memory better than I do. God bless.

[j-o-h-n]

Age/Meds that's the combination. As far as having an orchiectomy at age 93 I would think this would really put him over the edge. But I'm no doctor and only play one on Halloween. God Bless Him and you too.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/29/2022 1:15 PM DST

[Boywonder56]

93 and adt.....either way....might be time get orch........and enjoy whats left.....not being unkind just an opinion as a 66 yr old who has endured five 5yrs.....could only imagine at 93

[allrightABC]

Has he considered Radiation? Did a radiation oncologist mentions this?

[allrightABC]

Has a radiation oncologist talked bout radiation?

[Bvilkid]

Hug him, hold him, kiss him. Prayers for you both.

[Spyder54]

93 years…what a beautiful life ! Comfort him, love him. Dont allow this journey to be about medicine. It is about a life well lived. Time must move so fast at 93? A month, a year, 5 years must all blend together. This is a time for no stress. Many smiles. Many memories. I am 68, and Lupron, Prednisone, Zytiga, have clearly fogged up my brain. Simple calculations are sometimes difficult. On Wednesday, while playing cards w 7 buddies, I had a split pot (where half the pot goes to me, and another man). They asked me to split up the 35 chips in the center of the table-3 different colors. I started, then told the other man to finish it. So yes, we get brain fog from the meds. No doubt. My best to you and your family, Mike

[Hidden in reply to Spyder54]

Spyder, what exactly does your head feel like. Before my husbands diagnosis of prostate cancer, for almost a year he complained of a strange heavy feeling in his head, like maybe having a beer. Not a head ache , but hard for him to explain. This past January with a Turps they found the cancer too late, stage 4 spread to bones. No meds before the cancer but uroligist failed to watch rising PSA numbers. My husband was a world class power lifter, bench press. The best in the world for his age group 65 to 70 and 70 to 75. Never any drugs always competed clean, his entire life. We were not expecting this, just two years ago we were in Japan competing for gold USA. We are regular healthy folks, always together, always with our kids and grandkids, traveling and making friends. Our world crashed last January.

[Ming1828 in reply to Spyder54]

I am so thankful for the years we have been blessed with and we lived a good active life until we both became unable, but we still sit in our chairs in our living room looking at the beach and gulf with our memories and love our visits from children, grandkids and great grandkids. My concern is that I don’t want him to get in great pain. I had a 10 year old sister to die of bone cancer and that is one of my bad memories. God bless you and all the other ones that are experiencing this terrible cancer. I am going to suggest to his Dr that he be taken off ADT.

[MateoBeach]

So he is 93, with frailty and declining in various ways. Some resulting from ADT and lack of testosterone. Others probably unrelated. The ADT is no longer working anyway. So the side effects and any further residual slowing of the PC must be weighed against whatever possible quality might remain at the end of life. A difficult decision with no clear answer. Orchiectomy May not improve the side effects at all for him.A once monthly shot of testosterone (400 mg of testosterone cypionate) would likely make him feel very much better. And it can actually help to suppress the PC further, at least for a limited time. And if it does not it can always be stopped. To be discussed with his doctor(s). It is called BAT, bipolar androgen therapy. Much more about that is on this site.

[Ming1828 in reply to MateoBeach]

We went for his shot and Dr and we decided to stop treatment with ADT. I asked Dr how long he has. He said hard to say. Estimate months. He still does not complain of pain and our GP assures me he will keep him out of pain if he starts hurting. Bless all the men and families out there with this dreadful cancer. I think he is mentally better since he stopped ADT.

[MateoBeach]

Glad he is feeling better with this. Blessings to you both.