Continuing Lupron

[dac500]

On July 17, 2022, my last ADT vacation was ended due to some progression of metastatic lymph node cancer in CT scan at a PSA of 1.1. My MO put me back on Lupron for six months hoping that PSA would drop to undetectable by the end of the six months. A month of Casodex 50 mg before the a Lupron shot brought the PSA down from 1.1 to 0.42. During the first three months the PSA dropped from 0.42 to 0.29 on October 17. However, at the end of the next three months PSA didn't drop, it increased marginally to 0.32 on January 20.

According to my MO, this may be an indication of presence of some castrate (hormone) resistant cancer cells. So, my Lupron shots continue. I got one yesterday (1/23/2023) and get another one on April 24. If the PSA goes up further particularly to a value much higher than 0.32, that would indicate castrate resistant cells taking over.

I have lucky during the last four years Lupron controlled my cancer. Maybe I am running out of luck.

[Oldie68]

I hope you are not running out of luck! I don't know how long it takes after the cancer becomes CR to really ruin your health and make you feel miserable. I am hoping it will take at least another four years. Hang in there brother!

[Tall_Allen]

Your PSA is still very low.

[dac500 in reply to Tall_Allen]

I know my PSA is still very low. But there is indication that it may continue going up when T remains <20. Perhaps my iADT days are over. I don't anticipate addition of a second ADT for sometime.

[Tall_Allen in reply to dac500]

Could you please explain your reply?

[dac500 in reply to Tall_Allen]

My PSA is not going down when on Lupron (T<20). I was expecting my PSA would fall from 0.29 to close to 0.10, as it did on previous occasions. I expect my MO to continue with Lupron shots until PSA shows downward trend.

Here is part appointment (1/23) notes:

"Will continue ADT today with leuprolide given slight PSA rise - not castration resistant yet

RTC in 3 months for consideration of next lupron - if PSA rising still may consider additional imaging and/or addition of ARSI

In sum, we will continue lupron. RTC in 3 months for next PSA check. If continuing to increase we will consider ARSI.

David J. Vaughn, M.D.

Professor of Medicine"

[Tall_Allen in reply to dac500]

Thanks. Makes sense.

[StayingOptimistic]

we have similar stats. Wish you the best of luck.