Prostate Cancer Survivors






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treatment options after adt powered drop from 90 to 1

1/08 psa 65, 9/08 psa 90. Start androgen deprevation therapy (Lupron) now psa 1.0. Was planning on radiation therapy now not sure. Bone scans done 4/08,8/08, also ct and mri all no signs of mtastatic spread. Options; 1. radiation, 2.Continue ADT with PSA's done monthly or quarterly 3. Cryo-therapy 4.HIFU 5. Chemotherapy of a different type. Anyone with a similar experience ?? Larry

Re: treatment options after adt powered drop from 90 to 1

Hi Larry,
I was diagnosed in Oct. 06. Put simply, I had intermediate PC with a high chance of recurrence(29,3+4,T1c). I also have an uncle who had RP in 92 and recurrence around 04. While my experience is not similar to yours I have read alot about dealing with spreading PC.

If it were me, I would drop the chemotherapy option for now since your scans don't show mets and your PSA has made such a precipitous drop. As far as the other options it would be wise to seek answers from experienced specialists about the respective procedures.

You might also reply with your Gleason, Tumor Grade and age so that other mentors might be able to give you more information.

Take care - p (Alaska, USA)

Re: Re: treatment options after adt powered drop from 90 to 1

I could use some input from others who have rising PSA and considered ADT. My husband went to <.1 on two does of Lupron Depot. He skipped the third shot in what would have been a one year series (4 month intervals. The last short was February 2008. His PSA in September was 2.2, in November 14.6. He has appt with urologist Dec 5 when I'm certain the plan is to administer Lupron again. My question relates to value and effect of Lupron. I attended a session at the State University Prostate Center where the presenting MD said that Lupron does not extend life. If that is the case, why administer it, given all the negative side effects. Is there anyone out there who has had failed surgery or radiation and declined or stopped Lupron. I'd like to know what happens when PSA is allowed to continue to rise. I'd assume that at some point metastasis occurs, but if Lupron does not extend life, it must not prevent metastasis either. So what is the value?

Re: treatment options after adt powered drop from 90 to 1

Don't forget that ADT does not cure or destroy cancer. It only starves it. If ADT is your only treatment, you must remain on it either continuously or intermittently. Once you stop, the cancer will return.

You started ADT in preparation for radiation. It is expected that your PSA will go down due solely to the ADT. This shows that the cancer is being starved. Now hit it with radiation while it is weak. That is the standard ADT/radiation treatment.

Paul A. USA

Re: treatment options after adt powered drop from 90 to 1

Jo ... in addition to Paul's comments, ADT also helps reduce the size of an enlarged prostate as required for radiation seed implant which I had done last year.

Larry ... my situation was similar. PSA was in the mid 60's for several years then suddenly jumped to 115. All scans were negative for metastasis. After a positive biopsy I chose radiation seed implant (October 2007) followed by five weeks of external beam radiation, which I completed in January 2008. PSA in July 2008 was 3 with a normal DRE (finger) exam.

BTW, if you choose radiation, don't believe what the medical professionals tell you about side affects from radiation ... remember these four words: Pain, Burning, Frequency and Urgency.

While my urinary problems have improved, I still have pain/burning but the frequency/urgency has shown the most improvement. I only get up once or twice a night now (compared to hourly during and immediately following the radiation sessions). I've been on Flomax over a year now but have reduced it to every other day.

Folks on here tell me that this could continue for another year or so, unlike what the doctors told me last year.

Good luck with whatever course you choose to sail.

Re: treatment options after adt powered drop from 90 to 1

Hi Larry,

Like you, I had a high PSA (182), but no spread to bones or lymph nodes.
However, my tumor was a very scary T4.

My urologist considered Zoladex (Lupron) to be my only option, but luckily I got a good oncologist who put me onto 37 radiotherapy treatments once the hormone therapy had reduced the size of the tumor(5 months after diagnosis).

The combination worked incredibly well for me. I was able to stop the hormone treatment after 30 months of it and have now had no cancer meds at all in almost 15 months. My PSA remains stable at around the 1.0 level. The surge I had feared just never happened.

Very best wishes,