psa on the rise,hot flashes

[Hobie14]

Recently finished treatment,had first PSA test Apr 22, 2024

0.101ng/mL

Second PSA test Aug 20, 2024

0.493ng/mL

Is there anything here to be concerned with?

Should I be having PSA taken more frequently?

Still having hot flashes how long can I expect them to last?

Thanks for all the information.

[Justfor_]

Do you have Testosterone counts alongside the two PSA samples?

[Hobie14 in reply to Justfor_]

No, should I ?

[Justfor_ in reply to Hobie14]

Yes. If PSA rises while T is stable (low or high doesn't matter), it is concerning. If PSA and T rise together, it is inconclusive.

[Tall_Allen]

When did ADT end? PSA should go up as your testosterone normalizes.

[Hobie14 in reply to Tall_Allen]

Received injection 06/2023, six month dose. Told it would take a year before leaving system.

[Nodrogear]

I have been told that when the ADT ends my testosterone will return and may cause small rise in PSA but I am 83 so any rise will be slow and I am more likely to die before the cancer kills me!

[janebob99]

You should ask your PCP to prescribe one, large estradiol patch per week of strength = 0.1 mg (100 micrograms) per 24hr period. Apply it to your hip or buttock. It will greatly reduce or eliminate your hot flashes. It's called estrogen "add-back" because it replaces the normal/natural amount of estradiol that was lost because your testosterone was very low from ADT.

Alternatively, some men prefer estradiol gel to patches (divigel.com or estrogel.com). Apply 1-2 packets or pumps per day to the hips or buttocks.

For either gel or patches, titrate the dose until the hot flashes disappear.

I'm currently on Orgovyx ADT and use estradiol gel "add-back". I don't have any hot flashes and am expecting to have no osteopenia or osteoporosis.

Bob in New Mexico

[Hobie14 in reply to janebob99]

Thanks

[jackwfrench in reply to janebob99]

Bob - are you saying the estradiol approach also works to eliminate bone density loss? Jack

[janebob99 in reply to jackwfrench]

Absolutely. Here's a direct head-to-head comparison of transdermal estradiol (tE2) patch therapy to Lupron ADT (LHRH agonist). Estradiol grows bone, while Lupron destroys bone (because Lupron reduces natural levels of estradiol when it lowers T).

BMD change vs Time

[jackwfrench]

Some insurances will cover every 6 weeks which is what I use, and perhaps with your PSA rise you can get your MO to order a few out of cycle. My Hopkins MO told me this - We want to declare a therapy no longer effective when PSA is clearly going up. We look for 0.3 to 0.6 among the patients who are scared. 2.0 to 4.0 among the relaxed. We should wait for a PSA doubling time of less than 9 months. Anything less than0.3 is not useful unless looking for relapse after radical.

So maybe your team wants to look for a doubling of the .49 within 9 months.

[Hobie14 in reply to jackwfrench]

Thanks