Question on CRPC

[Cmdrdata]

I have been on Abiraterone for over 4 years which controls my PSA to <0.05. Initially, I also had Lupron which took me to castrate level and it stayed that way even till now it is still at <20 ng/dl. PSA started rising and doubling in the last 4-5 quarters. Onc says I should take Lupron. If I am already at castrate, what would Lupron do for me?

[Alturia]

I am on abiraterone and Eligard (lupron) and my testosterone is <2.5ng/dl. Perhaps you MO wants to get your testosterone even lower than it already is. What reason does your MO give for wanting you to go on lupron?

[Cmdrdata in reply to Alturia]

With My previous Onc, the lab report always show T as <50 (never actual value of castrate level). The new Onc started last week ordered a test for his baseline determination, This new/recent test showed my T at 4.6 ng/dl. I am scheduled to get my Lupron in a couple of week. One of the reason he said is that if I am interested and qualify for a future clinical trial, many trials require that I have shown castrate resistance via Lupron AND abiraterone (or other 2nd gen ADT).

PS: He also ordered new scans since my last one was in 2021. I ave no symptoms of met(s) or pain at this time

[Tall_Allen]

When castration resistance sets in, one of the reasons for it, is the androgen receptor makes many extra copies of itself on the surface of each cancer cell. This makes the cancer more sensitive than it ever was before to even the slightest amount of testosterone. That's why it's more important than ever to keep up the Lupron or other ADT.

[Magnus1964]

Just because you failed one drug doesn't mean you are castrate resistant. You can try xtandi, it worked for me.

By the way 4years on abiraterone is a great run. You may do as well on xtandi.

Magnus

[Hidden]

Hello my old friend. Seeing you post reminded me that Dr A once told that your goal is to have T <5. Could it be that is your MO’s purpose. I don’t know.

GD

[NecessarilySo]

Lupron lowers T, in my case to <3, and it keeps T low enough to prevent growth of normal prostate cells and CSPC. But Lupron effect wears off over time, like after 6 months, and T then increases, allowing more fuel for CSPC cell growth. So, the CSPC can grow, unless you starve it of T with new Lupron. The more growth you have of CSPC, the more likely CRPC can mutate and grow. Furthermore, if you resume Lupron, the question of CRPC and its treatment can be clarified and analyzed.

[Cmdrdata]

I have never had Sex Hormone Biding Globulin (SHBG) being part of my blood tests during all my prostate treatment history. Is this also called free testosterone?