Dad’s 6 weekly psa shows a little rise compared to the one at 3 weeks - grateful for any thoughts.

[Tinkudi]

Dad , 83 , was diagnosed in May with PSA 18 and bone mets as per PSMA scan.

Initially the plan was to do lupron and he was started on bicalutamide 100 mg daily , which he took for 3 weeks uptil 7th June.

But then we decided to go with relugolix and not lupron and the bicalutamide was stopped.

He has been taking only Relugolix from 8th June.

He had upper leg pain in one leg where there are mets in ischeum and femur. The pain went away totally after a few days of taking the bicalutamide and he resumed his daily walks almost and does some stationary cycling .

Did some blood tests after 3 weeks and now after 6 weeks I am surprised the psa shows a marginal increase at 6 weeks compared to 3 weeks. I am wondering if the initial bicalutamide could have influenced the 3 week reading compared to the 6 week one. He also took one dose of Denusomab 60 mg a week before the 6 weekly blood draw.

Would welcome any thoughts. 🙏🏻

PSA

1.124 ( 3 weeks)

1.170 ( 6 weeks )

Testosterone

38 ( 3 weeks)

26 ( 6 weeks )

[Justfor_]

A 4% rise can be very well attributed to measurement variance, maximally 20%. On the other hand, Bicalutamide's half-life of 6-7 days is, for practical purposes, enough to completely wash out initial contribution. Both cases apply. Difficult to tell if one prevails the other, vs witnessing the combined effect. Next test may render things clearer. Have patience, it's a marathon not a sprint.

[Tinkudi in reply to Justfor_]

Thank you. I know you are the bicalutamide expert 😊

[Justfor_ in reply to Tinkudi]

Thanks, In my case Bicalutamide proved extremely potent, but the general opinion on this forum is the exact opposite. Sensitivity and consequently results are patient by patient, not per trial. This is above the pay grade of silly docs and their parrots that only endorse "kitchen sink" approaches.

[Tinkudi in reply to Justfor_]

I was actually surprised that just in a week of taking only bicalutamide, dads pains disappeared.

[God_Loves_Me]

I would not worry till 4 PSA

[Tinkudi in reply to God_Loves_Me]

Thanks

[Simpson80]

my numbers seem pretty similar to yours. But I had not got them Tested at 3 weeks. Is your dad considering chemo ?

[Nfler]

Personally I use ivermectin as my main drug of choice but if I had to do some adt it would be very minimal bicalutamide as justfor uses it. Just enough for maximum effectiveness n ivermectin triples its effect, needless to say would use both… I’ve had great results w the ivm solely n quality of life is just thru the roof as my testosterone is back to normal n psa hovers 1…

[Tinkudi in reply to Nfler]

Hi.

Did you start using ivermectin on your own or did a doctor recommend that ? Needs immense courage and conviction to do own thing.

What kind of mets did you have. I see you had a favorable Gleason score.

Where have you read that ivermectin triples effectiveness of bicalutamide ?