Rising PSA on ADT

[MGBman]

Prostatectomy 2015, Gleason 4 + 3. 31 external radiation tx, ADT (Zoladex) 2015-17, post nadir Oct 2017 rising PSA until Jan 2022. Degarelix for 8 months. Two months after end of Degarelix PSA rising rapidly (doubling time 5 weeks).

Started ADT (Zoladex) Feb 2023. By Oct PSA 0.40 ug/L, Dec 0.43 ug/L, Feb 2024 0.46 ug/L. Small rises but still on Zoladex.

Do I assume that I am headed into the land of castrate resistance?

When does one ‘officially’ become castrate resistant?

If castrate resistant, what next? (I live in British Columbia, Canada)

PSAs booked for March and April. Onco appt booked for June

[Fiddler2004]

I think .4 is good. If concerned ask Oncologist about adding Zytiga (w/Prednisone ) or Xtandi to the mix. 🙏

[Tall_Allen]

Because of your rapid doubling time post-SRT, you may be a good candidate for the EMBARK protocol:

prostatecancer.news/2023/05...

Castration resistance is a process, not an either/or type of thing.