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I had a radical prostatectomy in August '06 Gleason score of 7 with cancer outside the prostate. By June of '08 my psa had risen from less than 0.1 to .25 so I had salvage radiation. That dropped my numbers to .06 last fall. Over the past five months they are up to .21. My surgeon has not called me but my radiation oncologist told me the the rise was "not good". I assume my next step is hormone or chemo. Do I need to get in immediately or can I get some of my work done and off my plate. I am a state senator and leader of my caucus, a stressful and very busy job.
I've been on Lupron since the end of May. My main side effects have been hot flashes and weight gain. I'm a company controller and have not noticed any decrease in my ability to function. I've been working out at the gym to help fight the possible loss of muscle mass. The hot flashes are uncomfortable however they only last a couple of minutes. Most days and nights I don't have very many, but other days I'll have multiple hot flashes throughout the day and night. I do find myself being a little more tired come bedtime, but it doesn't cause any problems.
Maybe I've been fortunate so far, but it hasn't been as bad as I expected.
I do not know how much my story can help, but I offer you my route. In Feb. 2001 I under went RP. My first PSa in June was 0.5 (not good)For various reasons I did not opt for Radiation or ADT. By March 2002 the psa reached 2.5 and I realized that I had to do something.
I was a chef which involved heavy physical work and was living by myself after separating from my wife. I had to find something that would not not have physical side effects and would not effect my quality of life. I tried Casodex 150mg, which within three months brought my psa down to undetectable. After a year with an UD psa I stopped taking the Casodex. It took three years for my psa to reach 5.1 when I started again on the Casodex.
For the last seven and half years I have been on and off Casodex. At the moment my psa is 2.8. My Onco is not keen that I re-start taking Casodex as he says that up to now we know that Casodex, for me, is very effective.
Besides enlarged and tender breasts I have not experienced any side effects. When taking Casodex one must have ones liver functions checked every six months. As chairman of The Living with Prostate Cancer Foundation and running three support groups in Israel, I come into contact with hundreds of men. Many of them are on Zoladex or Lupron. Most find it hard to function well because of the side effects. On the other hand I know of one who ran in the London marathon while on ADT. There are no hard and fast rules on how Hormone Therapy will effect one.
In your position I would monitor my psa, make sure that my daily schedule allows me time to relax and eat proper meals. You might have to make some hard desicions, but on the whole I would not rush into ADT at this stage taking into account on what you have told us.
