Low testosterone, rising PSA

[Alinur]

Hi everyone, I think my ADT holiday I s getting short.I had SBRT on spot found in the iliac bone and than 18 months of ADT( no Zytiga yet).stopped ADT and only almost 4 months my PSA is rising ( 0.038) from <0.006 on May.The problem is that the Testosterone is less than 50. Castration resistance?

I have 2 options to think about:

1) to wait untill PSA reaches around 0.7 or more and than another PSMAPETC as I did before.

2)ADT+ Zytiga immediately and see what happens.

Your opinions?

Thank you all.

[Concerned-wife]

please add information to your profile to help people respond.

[Hawk56]

I wouldn't say castrate resistance, after all, you stopped ADT four months ago and T seems to be recovering, albeit slowly.

Perhaps the questions to ask yourself is would option #1 change your treatment decision or alter the outcome of your PCa progression?

It's unlikely that waiting for your PCa to reach between say .5-1.0 would result in an out of control status, it could inform the treatment decision if you are open to radiation. Whether that would be SBRT only or SBRT in conjunction with a defunded duration of ADT and an ARI may be a function of the imaging results and your preferences for how aggressive you want to be in your treatment decision.

Option #1 may have the advantage of more time off treatment with a subsiding in the side effects (depending on T recovery).

Option #2 is not a wrong choice though it may not be necessary at this point. You could continue to do labs and consults, watch the PSA and then decide later without risk of your PCa getting out of control such that you lose treatment options.

Were this my clinical data I would way, let the PSA rise to between .5-1, image, then decide. That would enable more time off treatment and provide more clinical data to inform my treatment decision without the risk of getting out of control.

That has been my approach in managing my high risk PCa for the last 10+ years.

Clinical history

[BigTom123]

Seems that newer drugs like Nubeqa or Xtandi can be used as mono therapy. They don't require prednisone. Ask your oncologist.

[Tall_Allen]

Your PSA is negligible.

[Alinur in reply to Tall_Allen]

TA, I think my testosterone will never come back and although I have only 4 months vacation from ADT with no testosterone now, PSA rose from <0.006 to 0.038.Isnt that concerning? Thanks

[Tall_Allen in reply to Alinur]

It is negligible.

[GoBucks in reply to Alinur]

<0.04 is undetectable some places.

[j-o-h-n]

Geez. You're an 8 year member and no bio? Time to dip it in ink...........

Good Luck, Good Health and Good Humor.

j-o-h-n

[Alinur in reply to j-o-h-n]

John, I had my full bio in the forum.Now I see it's erased.I don't get it! I will try to post again......14 years history! Did they make some changes in the site?

[j-o-h-n]

They say a Gypsy did it.......

Hopefully you'll have 28 years of history to update.

Good Luck, Good Health and Good Humor.

j-o-h-n

[Alinur in reply to j-o-h-n]

I heard!

[j-o-h-n]

I know you heard........ she told me your fortune....

Good Luck, Good Health and Good Humor.

j-o-h-n