ideal biochemistry monitoring

[SimMartin]

question:

I know that there are protols for regular blood PSA and sometimes Testosterone when on SOC following RT and during the 2-3 years ADT (with localised high risk G9-10).

My excellent ONC does a full biochemistry every 3 months with a face to face meeting which is great, but I will have to move to self pay next year, and I am only 9 months into my ADT so far.

If I can’t afford it I will need to depend on the U.K. health system so will need to push for everything and pay in top for the extras. Is there a comprehensive list somewhere of complete best tests that covers monitoring not just the PSA and Testosterone (I also asked for FSH & LH).

I’m thinking of stuff like lipids, calcium, Liver, kidney etc etc. I would like to be PRO active not reactive - especially as in the U.K. the system isn’t good at preventative pro active monitoring, I need to do it.

[Tall_Allen]

What decisions do you suppose you will be called upon to make? That should guide the diagnostic tests you should get. For prostate cancer, I get nothing other than annual PSA, but biannual for you. I can't imagine what you do with FSH or LH. You may want other blood work for other purposes.

[Benkaymel]

My experience of the NHS regarding blood tests has been good. While I was on ADT (Prostap) alone I had 3 monthly full range blood marker tests and since they added Xtandi, I get them every 4 weeks. This will continue all the while I'm on this medication regime.

[maley2711]

Don't know...but perhaps have your Vit D checked and begin supplementation if low, especially with potential for SEs caused by ADT. also maybe ALP. or bone ALP, whic has shown some association with bone metastasis I believe.....TA might disagree? Yesterday well-respected MO mentioned the common problem of anemia when doing ADT....seldom discussed by our Docs, but not uncommon......and associated with tiredness whil on ADT!!!

Have you begun a disciplined exercise program?

[SimMartin in reply to maley2711]

yes - anaemia May be an issues especially for me as my other issues life long as a result of polio as a kid is breathing and muscle loss - and as almost no medic knows anything about polio and it’s effects and management I have to take responsibility for what is needed. Fortunately, due to vaccine, us older people with polio late effects are a rare lot now and medics have no experience,

Makes decisions around designing my prostate cancer treatment and management extra complex and individualised. They basically either ignore it, run away ir leave it to me. Hence after sacking two oncologists I have one who is super collaborative and supportive- hence my concern when I have to move out from private.

[maley2711 in reply to SimMartin]

so sorry for your struggles !!!!!!!

[Mgtd]

My Mo just checked my blood work for anemia. Gym, hike, weights but noticed I was getting winded on on step hill and had to rest at the top. Blood work was negative and probably an effect of low testosterone. But I was happy she was proactive on it.

[MateoBeach]

If testosterone is below castrate threshold while on ADT then LH and FSH are unnecessary, they will be very low. Annual complete blood count and metabolic chem panel are appropriate and routine. As is a lipid (cholesterol) panel and perhaps a TSH for thyroid.

He should have a DXA scan to evaluate for osteopenia which ADT causes. Bone strengthening regimens should be started early! Estradiol patch can also help mitigate bone mineral loss from ADT.

[SimMartin in reply to MateoBeach]

yes I am on biphosphonates as have some osteoporosis already and insisted on DECA after starting the ADT. I got the LH done as some odd rise in testosterone following a botched Zoladex implant to check if it was actually blocking LH - just me being neurotic I think as being told it’s ‘probably’ ok didn’t hack it for me

[MateoBeach in reply to SimMartin]

Well that’s a very good reason to check on the Zoladex with LH.

[maley2711]

Here is an anal.......

ncbi.nlm.nih.gov/pmc/articl...

[SimMartin in reply to maley2711]

thanks for that I do get ALP as part f my bone profile as I am on ADT and started biphosphonates to protect me as I have some osteoporosis - so will keep that ongoing