ADT Holiday Coming To An End

[6357axbz]

After nearly 2 years of undetectable while on ADT holiday my 10/2 PSA result was 0.1. Today, 10/23 my PSA was .19. Seems like a rapid doubling time. Sent result to my MO. Waiting for a response.

[Jancapper]

Did you mean that your PSA result from 10/02 was 0.1?

[6357axbz in reply to Jancapper]

Yes, O.1

Thanks for the correction

[ImDD]

How long were you on it before taking the "two year holiday?"

[6357axbz]

bout 3 years and 5 months

[Nusch in reply to 6357axbz]

Sorry, I don’t understand: You’ve been on Lupron 3 1/2 years and 2 years in ADT vacation? This adds up to 5 1/2 years and conflicts with you bio. Please advice.

[6357axbz in reply to Nusch]

ADT July 2018 thru Nov 2019 = 16 months

7 month holiday

ADT June 2020 thru July 2022 = 25 months

So total of 36 months

Approx

[GeorgesCalvez]

PSA results can swing up and down by quite a bit instead of moving in a simple fashion going up or down.

I suspect that your MO will want three or more results before deciding that you are no longer on the primrose path.

Good luck!

[6357axbz in reply to GeorgesCalvez]

I suspect so too George. My opinion is I the cancer is active again (pretty fast doubling time) and I’d just as soon go back on ADT soon in hopes it will slow things down like it did before. Now waiting to hear back from MO to see what she thinks.

[fast_eddie in reply to 6357axbz]

My PSA has been rising but a recent pet-scan came back clear. No activity seen anywhere. My urologist put me on what I'd call ADT-lite -- a finesteride prescription. Prevents T conversion to the real culprit DHT. So far no side effects. Too early to gauge effect on PSA.

[6357axbz in reply to 6357axbz]

Video conference with MO today. Her preference was to wait till PSA reached 0.5 for a good PSMA-PET scan, then do MDT if needed. I told her I thought that would be riskier than going back on meds now. She didn’t seem to think so. I don’t understand her point but she agreed for me to go back on meds if I was feeling stressed. She did acknowledge we were in a new world of treatment for PCa.

[TEBozo]

My oncologist is prescribing mono-therapy (Nubeqa) and I am starting today. Avoiding Lupron or Firmagon which is so fricking damaging to men's systems.

[6357axbz]

I will probably go back on abiraterone and add ragulavix (sp)

[dmt1121]

Spacing out these tests is better and more reliable. However, if you are following a protocol and it gets to .5 or higher, a Ga-68 PSMA Pet scan may be helpful to see if it has matasasized or is just a rise in PSA without metastases.

If you are not on abiraterone, your MO may wnat to put you on it. teh one thing I would consider is if it's worth waiting for it to rise enough for a scan to be effective. That will be up to you and your MO to discuss as to whether the waiting is too risky. Idid this when I became BR, using Axumin scan (lastest and greatest at the time) and it identied a lesion on my left femur and small tumor near my bladder. The lesion was effectively treated with SBRT and I ahave been on abiraterone and Eligard and for five years and have had a PSA of less than .05 since then. Hopefully it will continue to stay there for a long while.

It's definitely a judgement call based on your age and disease.

Good luck!

[6357axbz in reply to dmt1121]

Thank-you for your thoughtful reply. Above I wrote atorvastatin in error, I meant abiraterone. I don’t understand how my PSA would rise if it isn’t from cancer growing. I understand .5 is a threshold for an accurate PSMA scan but I don’t think I want to allow my cancer to grow to that level if ADT can stunt it where it’s at now.

[dmt1121 in reply to 6357axbz]

I respect that. As I said, it is a personal decision based on your age and disease. I'll also add, your own level of comfort with one direction or another.

[Jeremiad53]

I did that 3 years ago, I went on Abiraterone, and I have been at .01 or less for a while. I hope they keep coming up with new treatments, and trust a little bit in the chemists to come up with one.

[j-o-h-n]

my 10/2 PSA result was 0.1. Today, 10/23 my PSA was .19. Seems like a rapid doubling time.

Seems like a nothing burger to me, but what the hell do I know?

Godspeed...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 10/24/2023 9:31 PM DST