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I used to post (an old hand) as Sir E Netta, based on my former boat's name of Sirenetta. The boat is now sold so I've moved to another more suitable pseudonym!
I have PCa which had been controlled for five years following radiation therapy and the use of Zoladex. The PSA number was starting to creep up then, when my bladder and prostate were removed to deal with bladder cancer (probably caused by that radiation therapy), biopsy showed that there was no bladder cancer and the PCa was confined to my bladder neck. PSA dropped to the previous nadir and then began rising again slowly over the past year. Then it became clear that (very unusually) I had PCa in what remains of my urethra. I agreed to take on Casodex to try to "hit the PCa from another direction". Since then, despite an unsuccessful surgical attempt to scrape away and cauterise the polyps in my urethra, the PSA has accelerated and over the last two months it doubled (still only 3.8, but enough to trigger thought of another treatment option). I am wondering whether the Casodex may actually have encouraged the PCa to make its own Testosterone (which was assuredly at castrate levels before the Casodex).
This may just be a mad thought and the recent acceleration a coincidence but I thought I should raise this with the forum's gurus before risking a silly discussion with mu Oncologist.
Aloha Old Codger,
Was only on Casodex for 2 weeks before Lupron so can't really answer that question. It was used to stop a spike that would spike when Lupron was started.
The PSA rise? Mine was 0.3 July 2012 after surgery and remained below 0.7 to July 2012. In the past few mths it has risen to 1.3, so you are ahead of me on that curve (also pathology of bladder & prostate ... no cancer). Docs don't seem bothered & haven't made any comments. Before the surgery, like you, I was "high risk". It would seem that 3.8 may be worrysome, but perhaps it is not. Sure would like to know what is causing the upward trend. It is also worrysome why your treatments on the remaining urethra did nothing.
So, where is this PSA coming from & what does it mean?
Hang in there,
Joe
There are instances whereby casodex at some juncture or some patients AR (receptor condition) can cause casodex to feed PCa and increase psa. I hear that the increases are somewhat notable and might not be as slight as yours is, e.g. say from psa of 2.0 to 15.0+, in such phenomena if one then goes off casodex abruptly something called AAWD (anti androgen withdrawal) can happen and psa will drop soon (thus you know it was feeding the PCa).
There are exceptions in PCa, and psa is not the best marker as high gleason scores and other reasons can have much less psa 'leak' so in rarer occasions some guys have low psa's but have nasty PCa disease, maybe even mets happening with low psa levels, it is more rare.
My guess (s.w.a.g) is you are not feeding it with casodex, you ought to see if you can find a doc to write an Rx for estrogen patches or DES or emcyt. Docs more apt to write one for patches, the reason is estrogenic drugs can cause direct apoptosis (PCa cell death), you might get lucky and clean up those cells in the area or atleast drive your psa way down and get more duration. I did similar idea after 2 yrs. of ADT3 and starting to fail it and got almost 8 years thereafter of low psa's and control, then that program failed and onto other drugs in the last year. You can take estrogenic drugs even with Lupron or casodex and one time recently when failing control I tried casodex+estradiol patches and got a new lowered psa in a doubling time scenario, but only lasted about 2 months as I am dealing with hrpca and into year 11.5 right now.
Probably typo and should be emcyt which is estramustine, a capsule form of another estrogenic type of drug. Dr. Fred Lee is alive at 30+ years now with incurable PCa because he used this drug, the story can be found on google (starts with Rochester Urology.....where he still works 1 day a week)
