Vacation time?

[pdold]

I'm starting year 5. I started in 2018 with PC a surprise finding during an MRI for chronic but low grade low back pain. For past 4 years I've had stable PSA varying from 7 to 11 and back. Treatment is Lupron and Zytiga +Prednisone all at standard quantities. MO considers this level as probably my nadir. No radiographic progression, no pain, Minor hot flashes. some fatigue. Weight rose from 170 to 208 but I have driven that to a steady 165 with diet and exercise. Muscle loss is noticable and has caused some issues when I try some of my old swimming/bodysurfing routines. (I'm 77) . Reason for all this is that I'm considering a drug vacation to build some strength back. My MO is a bit reluctant but less so recently. I understand the risks and the need for rigorous monitoring. Has anyone experienced say a 6-12 month vacation that can give me some suggestions on what to look out for?

[tango65]

A real vacation from castration means to stop therapy until the testosterone is greater than 50.

It can take months to get to those level after years of Lupron an abiraterone.

One can't decide a priori how many months after stopping the therapy one is going to stay on vacation.

If you decide to stop therapy ,measure PSA and testosterone every month and see what happens with the PSA when the testosterone start to increase . You can make the decision to stop and restart therapy or continue with the "vacation" at that time.

[Boywonder56]

With a nadir that high i wouldnt......yours is a light sleeper......a good nadir has at least one dot and one 0.....like .02 .007............i would hold the course......imho......bw

[Hailwood in reply to Boywonder56]

I totally agree

[pdold in reply to Boywonder56]

Interesting - I've wondered why its that high. - My MO did mention that this high nadir might relate to my initial 1700 PSA. which dropped like a rock when I started Lupron. Its been in current range for way over 3 years with no particular change in my radiology. My Mets are few and easy to see on scans which helps assess the progression if any. If I decide to try a vacation I'm not locked to any timing, Test results will tell us when its time to restart. My thanks to all.

PDold

[London441]

Do you lift weights presently?

[maley2711]

There is a pronounced loss of muscle mass for all men as they age...so not all attributable to ADT !!!

[NecessarilySo]

I was on what is called "intrmittent" ADT therapy at first. That seems to be what you are asking about. I tracked my PSA like a hawk. PSA gradually rose to 1-8 level and doc resumed Lupron. Each time it lasted for about a year. Circumstances allowed me to take a four year break, during which my PSA fose gradually to 35, before i pulled the plug and am now on "continuous" Lupron shots quarterly. I'm your age. After a four year vacation, scans showed that the disease had progressed. Several suspected metastases had begun. Since then, I have been fighting them back.

You gotta realize that nobody is the same in this game. Just do what you think is right.

[fireandice123]

I’ve taken 2 vacations in the last 5 years - 9 months and about a year. Both times my PSA at the time of staring the vacation were quite low - undetectable and 0.1. I understand the need to take vacations. The side effects wear on you, even if they aren’t terrible. However, IMHO your PSA level is pretty high to be considering a vacation. I don’t think I would have considered one with a PSA that high. My vacations ended when my PSA rose above 2. That said, you know what you need to get back some semblance of QOL. If you are willing to proceed and understand the risk I would be very very closely monitoring my PSA, at least monthly, to make sure it doesn’t get out of control. Rather than planning on a vacation length in advance I think you need to let your PSA (or other symptoms that might pop up) be the determining factor for how long your vacation will be.

[SteveTheJ]

Cancer never takes a vacation.

[cancerfox in reply to SteveTheJ]

If cancer took vacations, doctors wouldn't be able to afford theirs! 🦊

[Boywonder56 in reply to cancerfox]

Great reply..........

[Zengal79]

My guy took a vacation against Doctor’s advice. I’m not saying it caused his progression, but I didn’t think it was worth the risk at the time and leaves me with a lot of what ifs now that he’s gone. Just my two cents. I wish you all the best.

[Adlon57]

Been on the PC trail since last June TOLD "caught early" have adenocarcinoma grade 7, in the 20 radiation therapy sessions, homeward over halfway, but my bladder is a bit of a mess, passing urine is painful, stool is just plain goo, watery, night-time endless journeys to the loo, next room, actual sessions are a breeze, but journeys back and forward, absolutely exhausted, then I saw weather forecast for next week, SNOW! My osteoarthritis is always bad this time of the year, but cold and wet, living on my own🙄🥴😤 I'm 66 was looking forward to that pension vacation, then this🙄 My living wage went up by £55 a week, June 2022, thought I could afford it THEN? ps have not had a vacation in 9 years😤