I have been researching and I have been wondering if big drops in PSA right after hormone treatment should give you more hope at a cure or if this does not change the situation at all?
Father PSA of 226 dropped to 3 one month after Firmagon shot, and then 0.3 a month after that, and then 0.13 a month after that. Is this something to be optimistic about? or is this typical for everyone regardless of the progression of cancer
Listening to the prostate cancer research institute on youtube, they say lupron would drop most peoples PSA by approx. 90% in one month and needs to be under 0. 1 within 4-5 months and if not, it indicates something is wrong such as early on hormone resistance. Firmagon is more aggressive as it instantly blocks testosterone which likely explains why my fathers PSA dropped over 90% in one month.
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FormulaRob
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When I first started ADT I recall my MO saying studies had shown that if PSA fell to 0.3 or lower within 6 months it was a sign of a good prognosis. At the time I didn’t inquire further for more details.
Just reading it, it seems that would be castrate resistant cancer. Or maybe it means once castrate resistant, it goes back to initial ADT treatment response before the patient was castrate resistant
Its a bit hardn to follow all these different studies. But one fact stands out. Dr. Scholz refers to PSA less than 0.1. This and some other studies stop at 0.2. Does that make a difference? If so how much and what kind? Intiatively for a layman it would seem the lower the PSA, the less cancerous activity remains, and the better prognosis.
Another question why the study stopped at 0.2? As they say there are stats and there are stats. In any case, there might be any contradiction as first appears.
Not based on any paper or trial I would second 6357axbz as it makes more sense to me. My reasoning is the following: Cancerous cells are heterogeneous. There is a whole gamut spanning from those very hormone sensitive, during the initial stages of the disease, to those totally unbeatable at the terminal stages. The PSA drop speed is indicative of the composition of the mix. Fast drop tells us that the population of the hormone sensitive constitutes the majority, hence easily killed or put to sleep. Slow drop combined with a low nadir number tells us that the target was not an easy one but for the time we are winning. Now, why do I prefer the second case over the first one? Because we know that the cancer cells evolve with time. In the first case the void created by the easy killing of the hormone sensitive cells will be filled up with harsher ones. This will also definitely happen in the second case, but at a slower pace.
For this reason, in my personal case, I don't feel at ease at all now being undetectable i.e <0.01. My target is a detectable but STABLE PSA <0.06. IMO we need the hormone sensitive cells to act as placeholders because we posses the means to control them. But I digress.
That is interesting. If you were to assume that it can't be cured then maybe you are onto something. Since what you speak of sounds like new cancer cells/ reoccurring or just further growing/spreading
So possibly a quicker PSA drop may indicate a higher chance at curative but poorer prognosis if it reoccurs or progresses further. I am going to reach out to Dr. Scholz at prostate cancer research institute asking him this and bringing up your current view. Curious if they have an opinion and if so where it sits
You are right, my axiom is that there is no cure but only disease management scoping to buying time. Haven't you noticed that drs when they speak publicly or in writing they abstain from using the term "cure" but instead resort to "curative intent". Doing this they protect themselves from legal hurdles as "intent" can't be prosecuted.
Hi yeah this is the video that sparked my questions. He says it as a good thing but some opinions here are the opposite. I am very curious and will be digging further into this
From my own experience, my PSA never exceeded 6, although I was Gleason 9 with lung mets at diagnosis. I was on casodex briefly, but less than 2 months into treatment with lupron my PSA was at non-detect levels. I was told that I had 2 years left at best, and now (2.5 years later) I’m still at a non-detect PSA.
I’ve been told by MOs that early response was a positive indication, and I’ve been told by other MOs that my quick response was less than optimal. It’s my belief (for what that’s worth) that this disease is so heterogeneous (see the recent post on body hair by jmarsh) that although there may be a preponderance of opinion one way or the other, no one can predict how any one individual’s body will respond
I haven't read any studies re your question> I will say that no study will tell you what lies ahead for your Dad.....only a probability of this or that outcome.
PSA was 2400 and 2600 in September 2020 put on Xtandi in November PSA dropped instantly to 0.02 although I was a Gleason 8. I take four tablets a day at 17 -00 pm and had all the side effects at first, hot sweats, restless legs, fatigue. Don’t have any side effects now and my PSA still remains at 0.02. Thanks for these tablets they are a God send.
Gleason 4+3=7. PSA dropped from 4.9 to .008 within days of starting Orgovyx 18 months ago. Ten months later PSA started to rise slowly. Now at 1.8 and still rising. Doctors declared me castrate resistant. The same scenario three years ago with Lupron.
My husband has taken 6 years to get below a 1 PSA. His scans look great- and it has steadily dropped- but not fast at all. So I would say there isn't really evidence that dropping fast means better response- and there isn't evidence that dropping slower means better. It is really individual.
The PSA drop is important without a doubt. PSA feeds the cancer basically. That being said, you can be undetectable and there is still a small risk that you can develop metastasis. Monitoring is import and everyone's numbers and situation is different. Don't overload too much on information - talk with the MO, and even seek another consultation with a different doctor.
Diagnosed with Gleason 9, about 30% of prostate involved - radical prostatectomy with 1 lymph node showing cancer activity. Went undetectable for nearly 3 years, no other treatment. PSA rose slightly and PSMA scan showed 1 spot in pelvic area. On to hormone therapy (initially tried relugolix, not enough response) moved to 1 month Firmagon to bring down PSA prior to 2 months of Radiation therapy. After 1 month moved to Lupron (6 month shot) all of this with Abiraterone. PSA undetectable or nearly 1 year (just had checkups w/both Radiology & Oncologist). This is good - but not a cure or remission at this point. My protocol is to continue hormone for 1 more year, then assess. In the meantime, exercise is important and adjusting some of your lifestyle. Sleep is important, good diet and a positive attitude. Never be afraid to talk to the doctors and others - take in the information - then weigh the directional path.
That is incorrect. PSA does feed cancer. It is an enzyme that prostate cells make that can elevate when any number of traumas to the prostate occur such as cancer, infection, physical trauma (even riding a bicycle).
Testosterone is what feeds most prostate cancers. That’s why we get drugs to turn off testosterone.
I'm sorry I meant to put it as testosterone. PSA can be used as one indicator of cancer activity. Sorry about that. Interestingly there is work with TRT where increasing testosterone is used to fight prostate cancer. It's not for everyone, but research continues as to where it fits in treatment. Thank you for noticing my error.
This study helped me make the decision to stay on ADT Lupron for a total of 21 months...the longer you stay on and the lower the PSA stays the better the outcomes...BUT (there is always a but) ADT does a number on your body...the side effects are dramatic...for me what did the trick was physical workouts with weights in the gym; 4 times a day and biking 6 times a week...the more physical exercise you do the less the side effects...but check out these two posts...good luck. Rick
My understanding is that a rapid decline in PSA after ADT indicates the stronger effectiveness of the drug to block testosterone. It does not mean less cancer, just less T. Less T means slower hormone-sensitive cancer growth.
Yes , It’s great news ! A CURE is a big word not offen used with #4.. However, it’s possible to keep it down for years . I went undetectable with a one month firmagon shot after imrt then on to lupron until an orch allowed me to drop the shots . No t no psa no signs of pc for over seven years . My dad had this also . This makes us 50% more likely to get this . Please You must start checking your psa at 40. I did not . I almost died at 53 from pc tumor k failure. Don’t do that .. love your dad every second . He’s on a good path with you by his side . . There are no promises given with this disease. Live in the present .. Good looking out for him! ❤️🙏🏼
Yeah he did the genetic testing and they said his prostate cancer is from hereditary causes. His sister passed from Breast cancer at 55 years old a few years ago which is apparently the same mutation.
I am waiting in line for a family doctor (haven't gone to a doctor since i was 18.. nearly 12 years ago) . But this has all showed me the importance of one. Apparently I will either have the same gene (this gene increases odds for prostate cancer, breat cancer and pancreas cancer.. not sure if i am forgetting any) .. anyways either I also have the gene OR I don't.
I am very happy to hear that you got through that major scare at 53 years old ! Life is crazy and scary. Up until maybe 3-4 years ago, I believed majority of people live to old age with rare exceptions.. I miss being that naive. On the other hand I am more grateful for things around me realizing we truly don't know what tomorrow has planned for us. YIKES !
Wow Rob , I’m sorry about your sister . Too young . F . You’ve learned a lot . Tom is not given for #4!. Pluck this and everyday . My dad had this my beloved uncle Ed passed from this . I went to see him a few days before he checked out . The home hospice nurse was giving him his first morphine shot . She was going to,aske him something . He said I know what you’re going to ask me . He said. “ I am at peace with my maker , I’m ready to go . That blew me away . The strongest faith I’d ever seen . Live healthy and check while young but don’t predict anything on yourself . I’m the youngest of four boys . Yet I was the only one to get pc . I’m thinking because I never learned to rid stress or anger from myself in a positive manor . I would always seat the little stuff . I’m think a live with too much daily steps invites disease . Thank you replying to me . Enjoy life . 😎✌️
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