Do all MOs monitor LDH regularly? Our MO in the UK does not. Whenever we have a chance to get it done, we monitor it ourselves. If I look at my husband's ALP, it does not seem to correlate to PSA rises in a pattern but LDH appears to do so. In June, before starting Docetaxel, his PSA was 99 and LDH 342.Docetaxel 4 is due today - his PSA is 414 and LDH 1250. If you look at papers on LDH, it seems to have a role in PCa development.
If something does not affect the treatment choice, it is not monitored. So far the MO is reluctant to try Cabazitaxel instead of Docetaxel. A bone scan is ordered now but no date set yet. He said that he could not change to Cabazitaxel without us being in a clinic and signing a form . That was not done before this chemo no. 4 today as they offered us only a telephone appointment despite knowing that Docetaxel does not appear to be working at all. If a scan was needed to see what to do we have had three weeks since the last chemo. It is sad to see that decisions of what to do for an advanced PCa patient appear to be made in such off hand manner.
Written by
spw1
To view profiles and participate in discussions please or .
My MO does not monitor mine. I am in the UK also. But your husband's PCa is more advanced than mine.Here is a paper on the prognostic value monitoring LDH.
All cancers use the LDH enzyme to acidify their environment and resist chemotherapy or the immune system. So inhibiting LDH is an important therapeutic goal, but there is currently no approved drug for it!
We have an MO who does not believe that Docetaxel is not helping. The hospital team thinks that the next one will start helping and then the next one. But another marker like LDH being high (not just the PSA) has some value in informing a decision to change to at least to a different type of chemo or to order imaging to check progression. What is the point of giving a toxic treatment which has no benefit? Symptomatically things are not better than before the treatment either. It is better to have all the evidence together in order to make an informed decision rather than trying the same thing each time expecting it to be different. I pray that Docetaxel may work for my husband; indeed I had high hopes for it. But it has shown not much evidence of it so far.
If he doesn't believe the PSA, will he believe the LDH? It sounds like he needs to say what evidence he is willing to accept. Is it possible to get a second opinion from Johann DeBono?
He has yet to see the LDH as we had it done in London on Friday. Prof De Bono does not have an advisory clinic. We hope to have an option of a suitable trial with him, if eligibility can be established. Scans are rationed but our MO would believe a scan. If we lived near India, we would do these investigations ourselves as scans are affordable. Having said that a January 2022 bone scan showed active disease on right side of hip only, based on which at the end of March that side was radiated. Imaging too needs to be done timely. as that treatment did not seem to do anything to hold the disease back even in the right hip. Last night he had an unbearable pain in the right hip, a few hours after the chemo (despite being full of dexamethasone and prednisolone). My post was written to help others who have a choice to keep an eye on LDH to do so before PCa starts to cause symptoms. My husband has been given hope one after another session that Docetaxel might work. Since our LDH test in India which we shared with MO, no further LDH testing is done until we were in London at Royal Marsden to try to check about his eligibility for any option of a trial.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
How to monitor intraductal PCa that has low PSA production?
Options when Docetaxel stops working 
Chemo (Docetaxel) not working 76 YO
NEPC -Chemo not working
