PSA level six months Eligard

[toyman79912]

I was diagnosed with PC in September 2022 with PSA level of 35 and had my prostate removed in January 2023. Since then, I started ADT in June 2023 and went through 39 sessions of SRT. My current PSA is 0.008 ng/mL. My doctor gave me a choice of continue with ADT for another six months which I already decided to continue. My question is what is the benefit of continuing with ADT for another six months. If I am offered another six months of ADT after that, should I continue?

[toyman79912]

Also, the lab work was done by Lab Corp. Is PSA of 0.008 consider non-detectable?

[Blackholes in reply to toyman79912]

Only if there is a less than sign in front of it. <0.008

Still very low level either way.

[Tall_Allen]

In the SPPORT trial, they used 4-6 months of adjuvant ADT when they gave salvage radiation:

prostatecancer.news/2022/05...

[toyman79912 in reply to Tall_Allen]

TA, so what you are saying is that more is not always better; 6mo vs 12mo ADT?

[Tall_Allen in reply to toyman79912]

No. I'm only telling you what was tested, not what is optimal.

[Darcym1 in reply to Tall_Allen]

Your trial seems a bit misleading, and there does not seem to be alot of evidence at present to go with 6 months vs. 12 months. I was on ADT with docetaxel (2 yrs and 6 months, respectively. I started with Stage 4 PC, PSA over 100. Cancer through my pelvis and in my ribs. I was first diagnosed in oct 2014. Still here and doing well with psa <1. So in my case, the longer term ADT seems to have been worth it. Still have my prostate.

[Tall_Allen in reply to Darcym1]

You are in a completely different situation from the OP. He is undergoing potentially curative therapy, whereas you are metastatic. Your ADT is lifelong, whereas his is adjuvant.

[robert570]

I have been on a 10 year journey with PC and you should continue to stay on the medication as long as it works. When your PSA starts rising, that's the time to consider to move on to the next drug. Also remember when you have moved on to the next medication, that your PSA should level off a point or two either way. My oncologist looks for consistency and leveling off, which means the medication is working. My PSA for the past 10 years was a low of .17 to a high of 2.56. Now, having said that, my last medication has stopped working and I'm currently on Jevtana with Carboplatin. My PSA had rose to 20.83 due to the failure of Pluvicto, which caused my PSA to rise from 2.56 to 20.83 within 3 months. Praying that the new medication stops the rapid rising. Good luck and remember that everyone's journey is different.

[Westee]

Toyman, I took Eligard shot once and switched back to Luperon. Eligard was too painful for me.

However, after I discussed side effects (memory, confusion, instability, headaches, and more) with my medical oncologist, he suggested a 6 month “holiday “ from Luperon to begin 1/2024. My Psa will be monitored monthly (currently .008) and will cancel holiday if it returns to .5.

Good luck. Westee

[Brokedown_Palace]

Although your lymph nodes were pathologically negative post surgery and your surgical margins were negative, your increased risk factors include 1) Gleason 8 disease, 2) locally advanced cancer (seminal vesicle and prostate bed involvement) and, 3) from the information you provided, your PSA never became undetectable post surgery. I assume the decision to extend ADT would be based on the balance between ADT side effects and the potential for improved oncological outcomes, particularly in case you have undetectable micro-metastases that the extended ADT might kill or at least suppress. Most importantly, if you haven't already done so, ask your medical oncologist to provide the pros and cons for extending the ADT, and consider seeking a second opinion.

I am in a similar situation, with Gleason 9, a very small amount of cancer in 1 out of 35 lymph nodes (like being a little pregnant?), seminal vesicle involvement, extracapsular extension, clean margins, and undetectable PSA for 16 months post surgery then 0.05 ng/ml. I just finished early salvage RT and my medical oncologist is recommending 24 instead of 6 months ADT if I want to optimize my oncological outcome and accept ADT side effects. I plan to go with the 24-month ADT recommendation, in part because I am tolerating the ADT well since starting it 4 months ago: 1) hot flashes improving from horrible to a few mild ones/day, 2) weight down a few pounds and waist down a couple of inches and muscle mass/strength improving with daily aerobic and 3x/week resistance exercise and reduced calorie/preserved protein intake (following Peter Attia Outlive book), 3) despite T < 10 ng/dl, still having some libido and erections are no problem courtesy of my inflatable penile prosthesis, and 4) emotions much improved with my new practice of mindfulness meditation following Sam Harris Waking Up book and "Waking Up" app with its great introductory meditation course, lectures, and other content. The app costs about $100/year (if you buy on his website) and he will provide it for free if you tell him you can't afford it.

Best of luck.

[toyman79912 in reply to Brokedown_Palace]

I too am tolerating adt well. Aside from hot flashes during the night time and losing muscle mass I am doing ok. I think my workout routine has helped me a lot in fighting off fatigue. That is why it didn’t take long for me to decide to go for my second dose of a six month eligard. I have the same thinking that the longer I can stay on the eligard, the better chance that the lack of testosterone will starve or kill those litter boogers. Thank you all that responded to my question

[bean1008]

I’d like to know how you got a PSA of .0008. Mine has never been reported lower than < .03!

Best wishes!

[toyman79912 in reply to bean1008]

It is the ultra sensitive test the doctor ordered for me

[toyman79912 in reply to bean1008]

also, it is 0.008

[j-o-h-n]

Stay the course, of course......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/19/2023 4:51 PM EST