Good news or bad news?

[CountryJoe]

Hello my brothers and sisters. Six months into my vacatión from ADT (Zoladex), my PSA has risen from point 13 to point 40. Is this reason to celebrate or to be worried? It is obviously rising, but slowly. My hope is to make it to a year with PSA under 2.

[6357axbz]

With the new PSMA scans (Pylarify, GA69) I think 2 is an outdated flag for PSA. Your profile states you have bone Mets all over. I would end the vacation because your PSA numbers indicate steady tumor growth.

[Kaliber]

it’s just my own IMHO, but personally I’d never take a vacation ( I’m pa’ve Mets too ) and let those little buggers regroup and rise again. ( as much as I’d dearly love a vacation). I’m keeping the pressure on / my foot on their throats as long as I can.

Your psa is still low, that’s a good thing …it’s rising , “ that’s “ not good tho. Rising fast or slow, in my case is jump right on it , and drop the hammer on it.

Just my 2cents worth …

Hope you have a great Christmas and holiday season brother, I’m giving thanks for still being here to spend time with my wife.

🎅🍾💪😁😁❤️❤️❤️

[CountryJoe in reply to Kaliber]

Good for you, Kaliber. Have a great Holiday season and many years, friend.

[Kaliber in reply to CountryJoe]

❤️❤️❤️

[Tall_Allen]

Didn't you have curative external beam radiation for high risk PCa? If so, there are no vacations. There is 2 years of ADT and that is it.

[CountryJoe in reply to Tall_Allen]

Thanks, TA. I had some radiation, I think 8 sessions more or less, along with 31/2 years of ADT (Zoladex). In that time my PSA went from around 145 to .13 where it stayed for a year. In June my onc suggested a vacatión until my PSA climbed back to 6. That's why I am still happy that it is less than 1 after 6 months.

[Tall_Allen in reply to CountryJoe]

Have you had a PSMA PET scan to see if there are any metastases?

[CountryJoe in reply to Tall_Allen]

Thanks TA. I had a scan 3 years ago and it showed lots of metastisis in bones (ribs, spine, shoulder área, pelvis, etc). After 2 years of ADT with some radiation, the same scan showed much improvement with many of the leasions significantly reduced or undetectable.Treatment here is rudamentary, TA. Equipment is old and outdated, doctors are poorly trained and not very motivated and treatment options are límited. It is all to say that we are in God's hands. We are also more fatalistic, I suppose.

I exercise vigorously every day and pray. Those are my options and they have kept me going strong 4 years into this struggle.

[cesces in reply to CountryJoe]

Where are you located?

[CountryJoe in reply to cesces]

El Salvador

[tango65]

What is your testosterone value?

There is a difference if the PSA is increasing with a testosterone over 50 than if it is increasing with a PSA still at castrate levels below 50 or 20.

If it is increasing with a testosterone a castration level the cancer is becoming castration resistant. If the testosterone is 50 or more the testosterone may be causing the increase.

It is very variable person to person, but usually it takes months for the testosterone to recover when one is on ADT. I would request to measure the testosterone.

[cesces]

You should be getting PSA tests at least once a month (maybe more frequently) until you know what the doubling rate is.

Only 2 or 3 reads isn't really enough in my opinion.

[CountryJoe in reply to cesces]

I agree, cesces and do test monthly.

[Don_1213]

As @tango65 pointed out - you need T readings to go along with the PSa readings. My medical oncologist - in viewing a lab report done by my urologist (now ex-urologist) asked " Where is the testosterone number? " He said "PSa without testosterone is worthless.."

You said you're 6 months into the vacation - that's about when T recovers after ADT if it's going to recover... so an increase in PSa wouldn't be a surprise especially since you still have a prostate.

Is there any possibility of getting to a country for treatment where PCa is taken seriously?

[CountryJoe in reply to Don_1213]

Thanks for answering, Don. I will follow your advice and get the T value. I have lived in El Salvador for 45 years and am in their public health system. No other insurance and not much chance of moving.