PSA still undectable

[Brysonal]

it’s been 4 months now since I didn’t have my ADT injection ( so 7 months since the last one). Continuing on Apalutamide as a monotherapy atm.

Pleased to have experienced Christmas and a 3 week hol in Barbados with no bad news as Decembers have bed. Dodgy in the past.

Back at work now - enjoyed a 5 week break. Flushes have reduced considerably, energy level seems improved and regrowing some hair. No sex life but starting to feel an interest

See MO next week, bloods are improved all round.

Will discuss possibility of coming off tabs as well for complete holiday.

stage 4 with distant mets on diagnosis but now heavily treated and NED on scans!

[PGDuan]

great to hear! Congrats and enjoy.

[Justfor_]

Bad idea, if I may. Reduce Apalutamide dosage gradually until a very low but detectable PSA is reached and maintained.

[Scout4answers in reply to Justfor_]

Would you please elaborate.

I have also taken my last 3 month Lupron on Dec.5, should be out of my system on or about Mar 5th

I have cut my Abiraterone back to one 500 mg with a 300 cal. breakfast. (The U of Chicago has found it to be just as effective a 4x on an empty stomach)

Do you think it is unwise to continue ABI?

Do you think I should be taking smaller or less frequent doses of Abi.

not sure I understand what you are advocating. Feel free to PM me if you would be more comfortable.

TIA

[Justfor_ in reply to Scout4answers]

First step is to hold off until Lupron wears out for good. If you were on a 2nd gen Lutamide this would be demonstrated by regaining normal Testosterone counts. But you are on Abiraterone that makes things trickier.

Second step is to have frequent, say monthly, 2 min or better 3 decimal places PSA tests, so you will know if it is trending up /down or stays "trapped" into the undetectable margin. If it starts trending up, Lupron was contributing, so abort the whole idea.

Third step, provided it is trending down or stays undetectable, find a smooth way to lower your dosage and retest PSA a month later. Abiraterone has a short half-life so it is advisable to have it reduced in a time proportional manner. For example: You are currently taking one tablet per day. If you want to reduce it by half, don't take a tablet every other day but instead half a tablet per day. Thus, a very conservative starting point could be 2.5 tablets per 3 days (i.e. days 1 and 3 whole tablet, day 2 half tablet) which amounts to 83% of what you are taking today.

[NPfisherman]

Great news...

It can take some time to get the ADT drugs out of your system... I had "hot flashes" for about 8 months after my last Eligard...

Best of luck with your MO next week, and your path forward...

Fish

[Scout4answers]

Wishing you the best , following right behind you Bry

[GreenStreet]

Thanks for the update. Great news. I hope it continues to go well for you.

[KocoPr]

Great news! Do you attribute it to the J591?

[Brysonal in reply to KocoPr]

I didn’t have J591. Started with a double shot of degerelix and 3 x Lu-177 infusions before 3 x Docetaxel, into 20 x VMAT radiation sessions, 2 brachytherapy’s and the OVM200 vaccine clinical trial. Oh plus Apalutamide and a bit of SBRT to a stubborn T9. No idea what did what and do keep reading about J591 and being me I never say never.

Current Apalutamide monotherapy and trying to live clean bar my red wine and rum sours of Barbados!

[KocoPr in reply to Brysonal]

Oh, reread your bio. It was OVM-200.

You have been through the ringer for sure, and came out clean! Good work! It could be the rum!