I was diagnosed with PC in April this year, Gleason 7 (3+4) with no mets.b
My PSA levels were:
15.61 (15dec, 21)
18.91 (25jan, 22)
28.5 (8jun, 22)
0.57 (2sept, 22)
I was given a 3 month lupron shot on 15 jun and 20 sessions of IGRT starting in August and which ended last week.
My PSA level was tested last week, the result was 0.57. I am naturally elated at the result which I think is due to the ADT and not the radiation which I understand takes up to 2 years to bring the PSA to its nadir. My oncologist said that if PSA level is <1, then there is no need for a 2nd lupron jab, which is good news.
Fortunately, I've been spared serious side effects of both the ADT as well as the radiation, apart from mild fatigue, loss of libido and frequent urination which I expect will diminish over the next few weeks.
I hope that recounting my journey with PC will bring hope to others in a similar situation.
Written by
John347
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I disagree with your oncologist. A PSA value of 28 puts you into high risk. If you had surgery, they would analyse your prostate and probably upgrade you to Gleason 4+3 or 4+4. You should contine with ADT, my recommendation is for 18 months.
I forgot to mention that soon after the PSA 28 test, I had a routine urine test which discovered that I had an infection in my bladder and I was immediately given antibiotics. That UTI was probably the cause of the spike in the PSA level.
An infection in the bladder will not increase the PSA value. An infection of the prostate does that. My recommendation is extended ADT to be better safe than sorry.
Stopping and restarting antibiotics selects for resistant bacteria. Similarly, stopping and restarting ADT selects for resistant types of prostate cancer. You have to do it right the first time.
You had a PSA of 28 and a 3+4 Gleason and your oncologist prescribed only 3 months of ADT? Was this actually his initial recommendation or was it that you refused any more?
Most of us (and most doctors) will tell you 3 months ADT is not enough in your situation. I would at least get a 2nd opinion from a reputable GU oncologist before staying with the suggestion to stop just because your PSA dropped to below .1, which is entirely typical with Lupron anyway
You mention ‘experiencing the harmful effects of ADT’, and that you’re glad to be rid of it. This is understandable.
However, you also say you have only had ‘mild fatigue, loss of libido and frequent urination which I expect will diminish over the next few weeks’.
It’s a nice thought, and that may well be the case. Or some of these side effects may intensify. Either way the fact is you are tolerating them well, and likely will continue to even if they get a little worse. Your fitness and strength are your greatest ally here, stay with it. If you stay as fit as possible the side effects should be only periodically challenging rather than also dangerous.
That you are tolerating it well is a good reason to go longer; ADT pairs well with the radiation, and decreases the likelihood you will have to get back on it later, which you obviously don’t want.
I'm not a physician but everything I've read supports continued ADT for a man with your dx profile. With 3 three mo duration shots, the Lupron side effects were devastating for me. You name the SE and I had it.
I also hired a wt trainer, biked and walked my ass off...and still gained wt, btw, most of which is still with me today. And, yes, my PSA and T dropped like a stone with the ADT. So, I understand what you're saying but, methinks, you're playing with fire.
My appetite decreased in part, I think, because of the stress related to what was going on - ADT, IMRT and brachyboost. Even 3 yrs later I have retained most of the wt I gained despite my best efforts. In part, I suspect, just because of aging and genetics.
I was Dx'd with PSA of 25 and 3+3/3+4-Tc3. Went with 20 sessions of IMRT + Brachy boost. Because of better daily drive had IMRT at diff site, so had two Oncos.
Brachy Onco is the primary, he prescribed 12 months of Lupron, two 6-month injecs. In the final visit the IMRT Onco wanted me to go with 24 months of Lupron. Brachy Onco over ruled that and stood by his recommendation of just 12 months, when I rechecked at 6-month follow up, four months ago. PSA then was 0.36
I've read about Dr. Kishan's study which now recommends 18 months while others say 24 months but may be my Onco is confident coz of the radiation boost I had.
My biggest problem with Lupron have been the hot flashes which are still happening but a lot milder now, almost ten months since the 2nd injection.
Thank you for sharing your PC journey. I think many oncologists just randomly prescribe 24 or 36 months long without regard to the patients who have to suffer the ill effects.
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