Initial PSA drop after 3 months on Lupron

[OldVTGuy]

I stared Lupron 1/17/23 and IMRT on 3/21/23

Got my first PSA test today and was 0.14 (was 18 before the injection).

This is 3 months after the Lupron shot. It seems OK to me based on what I have read - would like to see it below 0.1 after 4 or 5 months - correct?

Anyone with similar experience at the 3 month mark?

[Derf4223]

Sounds about right to me. Are you also adding Abiraterone or Apalutamide? What about Docetaxel et al? Are you oligometastic? Abi could drive your PSA to undetectable (get it from an online cash generic pharmacy -- eg scriptco.com.) As a word to the wise -- get your bone density checked ASAP. Lupron+Abiraterone+Prednisone accelerate bone density and muscle loss. I take 1200 mg/day Calcium, K2 Mk7 180 mcg/day, K2 Mk4 45000 mcg/day, Magnesium 200 mg/day, and exercise my arse off. Brisk walking, resistance exercise, and aerobics daily. My MO has me on Prolia for bone loss -- we don't stand a chance of avoiding early osteoporosis without it.

At age 60, hopefully you will be up to it all. I'm almost 69 and I overdid the foot stuff to the point I have plantar fasciitis, getting PT (pain therapy) for it as we speak and not stopping daily walks in the woods.

[OldVTGuy in reply to Derf4223]

I am non-metastatic so this is what I am on for now. I missed out on the Apalutamide part of the clinical trial I am in - 24 months of Lupron instead.

Hopeful at the 6 Mo. mark I'll be below 0.1

[Hidden]

EBRT/IMRT you just completed will actually raise PSA, until your body rids itself of those dead little PCa cells, they still give off PSA. Need to give hot time now.

[SteveTheJ]

FWIW, the highest my PSA ever was, was about 3.4. My first Lupron was 6-months (subsequent ones 3 months) and has been undetectable ever since.

[pjd55d]

yeah - for me PSA 400 at diagnosis - dropped to 27 and then every 3 months down down down - undetectable for 5 years = it will get lower as long as the med works - if and when that stops - there are lots of additions and other ways to treat it - your stress and panic levels should be low - exercise and enjoy life

Best

[jmarsh]

I had spread to lymph nodes and did 33 whole pelvic radiation treatments. I am on Lupron and Abi + prednisone. This is the new standard of care at Duke. My PSA has been undetectable since completing radiation. Regardless of metastasis, I would ask about adding Abiraterone + prednisone. According to the Stampede study, this improved recurrence rate from 50% to 20%. Just my little bit of experience here. Best of luck.

[OldVTGuy]

Interesting. I read the trail and it seems they are not sure about non-metastatic benefits but see it as the next step in analysis.

You don’t have any info in your profile but did you get IMRT on your prostate or just the broader area. I am getting 44 treatments - 25 to the the pelvic zone and 19 to the prostate itself. I think that’s common.

[groundhogy]

i had a 6 month shot.

PSA was 0.33 at about month 4.

Several months after the lupron expired it was measured at 0.04.

So there is some type of lag.

[Atdabeach]

My numbers are similar to yours. PSA 19.5 at diagnosis in June 2022, started Eligard and abiraterone+prednisone in July 2022, PSA dropped to 0.2 in September, <0,1 in October and November (these last three readings were from non-precision PSA tests), then 0.022 in January and <0.014 last week. I just completed 44 sessions of proton therapy on 4/7, of which 28 were full pelvis (due to some lymph node and possible seminal vesicle metastasis) and 16 of "prostate boost." I just got my 4th 3-month Eligard injection; will be on combined ADT for 2 years total.

[OldVTGuy in reply to Atdabeach]

Helpful thanks for sharing! I start my prostate boost IMRT this week.