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I am on Lupron and Casodex. My PSA rose from .67 to over 9 in the last three months. My doctor is saying that the drugs are not keeping my testosterone down. I am very curious if anyone else if having a similar problem and what their doctor is recommending?
Have you reached castrate level at any time or have the figures failed to get down to true castrate level?
Assuming the latter, then adding Avodart might help.
Coming off Casodex can cause the psa to drop in some cases if the Casodex is working against you.( Takes five weeks to leave the system.)
Low dose Ketoconazole + hydrocortisone is sometimes used to block testosterone production from the adrenals. Liver function needs monitoring if using this.
When Abiraterone becomes available, this will do a similar job.
Hi David,
I don't know your treatment history, or your age. Or if you still have a prostate.I couldn't see a profile on the site, which would help.
I had a similar problem with T-levels. I was on Zoladex and when the psa started to rise, adding Casodex 50mg did the job for me.
This does cause the T-level to rise slightly.
Some benefit from a 28 day injection rather than the 84 day one.
( Changing the LHRH can also benefit.)
Some try raising the Casodex to 150mg.
Or stopping Casodex to see if the cancer cell receptors have mutated and Casodex is doing harm.
Others change the blocker (Casodex) to another such as Nilutamide or Flutamide to see what happens.
Estrogen patches are another approach if required.
I did briefly consider surgery but could see no benefit. Perhaps my adrenals were producing some testosterone. Who knows !
Have a DHT test along with your next testosterone test. Adding Avodart will block conversion to DHT which could be where the psa rise is coming from. Although your T. will be low, DHT is far more potent to the cancer cells.
I assume you have looked at diet. I eat virtually no meat, no dairy or eggs. This helps I am sure. Lots of veggies & go easy on the carbohydrates.Less weight is better than overweight.
Some ideas to talk to your Oncologist about.
Hope this helps a bit,
Regards
Rob
Hi David,
Thanks for that.
I was diagnosed at age 51 and although I had to have radiotherapy & hormone treatment, we share a similar problem.
The testosterone level not sufficiently lowered by Zoladex.My psa also started to rise again and the Casodex hit this hard.
In fact the result was better than expected and confirmed to me the higher T. level was the problem.
Has salvage radiotherapy been mentioned ?
Do scans show any P.Ca. e.g. in prostate bed ?
Do pathology reports show likelihood of spread from prostate (before the surgery)?
I think you will have many questions for your Onco.
