Does PSA drop after starting ADT tell us anything?

[EvFC]

My husband started Firmagon shots a month ago. Before starting his PSA was 5.9. It was tested a few days ago and it’s 1.4 now. Does this tell us anything of any significance? Thanks!

[Tall_Allen]

Yes, it’s working!

[EvFC in reply to Tall_Allen]

Thank you! When you say “working”, does this mean preventing the cancer from spreading? Actually killing cancer cells? Reducing the tumour size? I thought I had read that ADT couldn’t actually get rid of the cancer, so it’s not clear to me what effect it’s having on the cancer cells.

[street-air in reply to EvFC]

it kills some - but others enter a Senescent state (that also makes them more vulnerable to parallel treatments) but at least functionally they remain in stasis.

[Mascouche in reply to street-air]

Just want to expand on this street-air. Maybe the senescent state makes them more vulnerable to SOME parallel treatments but I don't think it is true for all parallel treatments.

Some treatments, like chemo, work best against rapidly dividing cells (like cancer, hair and nails) so if the cells become senescent and slow down noticeably, then chemo should be less efficient.

What confuses me a little is that my understanding was that this situation of working best against rapidly dividing cells was also applicable to radiation and yet quite often the protocols used apply ADT + radiation at the same time rather than one after the other. I do not contest the outcome of why that combo works when taken simultaneously but it is counter-intuitive to me.

[EvFC in reply to Mascouche]

Thank you! I didn’t know this about chemo. That’s interesting.

[EvFC in reply to street-air]

Thank you! Interesting.

[Tall_Allen in reply to EvFC]

Firmagon stops all current cancer replication and growth. Many cancer cells that cannot replicate die. By itself, it is not a cure, but it retards progression and together with RT it kills the cancer.

(Sorry, I was confused by your posting in the advanced prostate cancer forum and assumed your husband has advanced prostate cancer. From his profile - he doesn't)

[EvFC in reply to Tall_Allen]

Do the cells eventually learn to evade the ADT and is this why it’s only a temporary measure? If so, how long does it typically take them to adapt? Thanks!

[Tall_Allen in reply to EvFC]

Castration resistance never occurs with adjuvant ADT. It is temporary because hopefully he will be cured by the radiation+HT and will need no further treatment.

[EvFC in reply to Tall_Allen]

Thank you!

[EvFC in reply to Tall_Allen]

Sorry, I came here when he was first diagnosed before we knew if it had spread, because his Gleason score was so high and the knowledge shared here was more relevant to his risk level. Now that we have more information about his current stage, I can move to a more appropriate group. I am grateful for all the information shared here.

[Tall_Allen in reply to EvFC]

I didn't mean to chase you away, but you may find the responses (including mine!) are more apt on the following site:

healthunlocked.com/prostate...

I normally just assume that anyone posting here has advanced PCa, and the answers are very different for localized PCa. But I should have read your profile.

[EvFC in reply to Tall_Allen]

Thank you

[fast_eddie in reply to EvFC]

Don't feel bad for being here. My prostate cancer is not advanced but I am here to learn what to do in case it progresses and becomes advanced.