PSA +

[TommyCarz2]

Is a PSA increase from .13 to .20 a concern? I'm on Eligard and Zytiga & Prednisone + Xgeva.

[raoulmaher]

Hi Tommy - I have heard that PSA doubling time how fast it doubles is more important than its level although obviously the lower the better ? - It looks like you are on a very good triplet therapy and I think I maybe not far behind you - I think I will be looking for Chemo next - I hope this helps

[dhccpa in reply to raoulmaher]

Is he on triplet? Didn't see chemo.

[TommyCarz2 in reply to dhccpa]

No Chemo here. Started with Eligard, Zytiga, Prednisone, and Xgeva, and have been on that treatment for a little more than 4 1/2 years. I went to Fox Chase for a second opinion, as I was contemplating the estradiol patch, and was advised to "Stay The Course, as I've responded Very Well to treatment. I was looking for an alternative because the side effects of 4 + years of ZERO testosterone are horrible

[dhccpa in reply to TommyCarz2]

Thanks. I guess I think of Xgeva as a bone treatment rather than PCa, whereas triplet includes chemo, but maybe that's being picky.

[AlmostnoHope in reply to raoulmaher]

Don't let them scare you with those low numbers. Strive for stability regardless of the count. It's always worked for me.

[Tall_Allen]

Discuss switching to 0.5 mg/day dexamethasone.

[Lslal in reply to Tall_Allen]

Is Dex to replace Prednisone?

[Tall_Allen in reply to Lslal]

Yes

[garyjp9 in reply to Tall_Allen]

T_A, what is the reason for your suggestion?

[Tall_Allen in reply to garyjp9]

This:

bjui-journals.onlinelibrary...

[garyjp9 in reply to Tall_Allen]

Thank you

[MoonRocket]

Have you had any discussions with your on MO on what to do? I feel empowered having the what if conversations. Then I'll do research on the options. What was your nadir PSA since starting the treatment of ADT + zytiga with pred.?

[TommyCarz2 in reply to MoonRocket]

I try to have discussions, but they play by the book and have blinders to anything outside the box. I do a ton of research and when I discuss articles written in The Lancet, or other well respected publications, they frown and say your psa is good, and THAT'S what we watch. I tried to discuss adding the estradiol patch to negate the bone loss and shitty feelings of having no "Man Juice" and they brushed it off as fools gold, even though the Lancet papers highly regarded the treatment as effective.

[MoonRocket in reply to TommyCarz2]

Maybe get a new MO.

[robobob7777 in reply to TommyCarz2]

It's frustrating my doctors don't care what PubMed and other scientific research has found they care about their procedure only

[Mascouche in reply to robobob7777]

The Canadian system at play. I live there too. Once in a while you get lucky and find an oncologist who knows what else is available as treatment, but one such person told me that he has to keep to approved Canadian standards otherwise things would not work out well him. I fired my first urologist after he told me that medicine is the same everywhere in the world. The bond of trust was immediately broken as it is not even the same in every province, much less for the whole planet.

[Gl448]

How long between those PSA measurements? What was the level before the 0.13, and time gap?

Is your ALP on the rise as well?

[TommyCarz2 in reply to Gl448]

I do every 3 months I was .11 in March then .17 in June, .13 in September . now .20. I'm probably worried over nothing

[j-o-h-n]

Make sure they shake the vial before they test it.....if they taste it.. see the manager...

(What else do you expect me to post?..........I don't know shit)

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 12/06/2023 11:48 AM EST