Xtandi already failing? How is this possible

[Mw921000000]

hi everyone. My dad met with his new oncologist today. He consented to genetic testing so his bloodwork will be sent out in 6 weeks. His new PSA reading came back at 2.84. On February 7th, it was 1.94. He also got another lupron shot today and it’s been over three months since he received one, maybe that’s why his psa increased? I don’t know. This isn’t good though and my anxiety is starting to get the best of me. Any advice?

[Tall_Allen]

Timely Lupron shots are important. Consider combining Xtandi+ docetaxel:

prostatecancer.news/2022/10...

[Mw921000000 in reply to Tall_Allen]

he had a 15 day delay, would this matter? Also, new doctor at MSK said chemo is jumping ahead too quickly and she tends to do it when there’s absolutely nothing else left

[Tall_Allen in reply to Mw921000000]

Yes, it matters.

All recent evidence is that early use of docetaxel is better.

[Mw921000000 in reply to Tall_Allen]

I trust the evidence. Should we have gone with a doctor who is pushing more towards chemo? Being that this is a top hospital, I would have thought they would have been more suggestive of the option, but they’ve been the opposite. I cannot begin to guess why

[Tall_Allen in reply to Mw921000000]

I've found that the specific doctor matters more than the hospital. Now that Michael Morris is no longer accepting patients at MSK, I think that Dana Rathkopf is excellent.

But an empowered patient can make a big difference. I always send emails with links to peer-reviewed journal articles that I want to discuss at the visit. This gives the doctor time to think about issues of importance to you. Doctors are busy, so a "heads up" is always appreciated rather then putting them on the spot.

Here's what I know about timing of docetaxel:

prostatecancer.news/2019/02...

[Mw921000000 in reply to Tall_Allen]

Thanks so much for this. Is she at NYC location?

[Tall_Allen in reply to Mw921000000]

Yes.

[Gl448]

”He also got another lupron shot today and it’s been over three months since he received one, maybe that’s why his psa increased?”

When was his last Lupron shot and what was the dosage of it? Lupron comes in multiple different dosages anywhere from 1 to 6 months.

Did he intentionally decide to not get his last shot timely, or did his medical team not schedule or remind him? If the latter, time to find a new doc in my opinion.

[Mw921000000 in reply to Gl448]

December 14th was his last one. March 15 was supposed to be his next injection but his doctor at MSK, a “top cancer hospital” decided to cancel his appointment the week of and not even contact us. If I didn’t check his portal we would have been on our way to the city. I doubt the 15 day delay would matter too much, would it?

[j-o-h-n in reply to Mw921000000]

Who's his M.O. at MSK? Where is your Dear Dad located?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/30/2023 7:09 PM DST

[Mw921000000 in reply to j-o-h-n]

MSK in nyc, his old doctor was Lewis Kempel, he was the one who cancelled lupron appointment and didn’t notify us, he just retired (I think this is why he was slacking off for the last 6 months), but we just were assigned to Susan Slovin. So far we like her. Who do you see at MSK?

[j-o-h-n in reply to Mw921000000]

I see Dr. Michael Morris...... (for many years)........I've seen Dr. Slovin's name here many times, with all good comments (reviews). Give My Regards to Your Dad...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/30/2023 10:37 PM DST

[Teacherdude72 in reply to Gl448]

Personally I choose monthly Lupron. With the linger dose I have fewer side effects the weeks before the next dose. Monthly never seems to wear off.