Prostate Cancer Survivors

 

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Re: Almost Diagnosed?

Update:

PSA trajectory
220 (15 days prior to biopsy and 25 days before start of ADT)
20 (6 weeks into ADT)
5 (a little less than 12 weeks into ADT)

Testosterone seems to have stabilized at 29 ng/dl with Trelstar and I think it's as low as it's ever going to be with LHRH analogues. What are my options?

1. Increase Casodex (bicalutamide) dose to 150 mg/day
2. Add Avodart to the mix
3. Surgical castration to try and bring it down below 20 ng/dl
4. Something more aggressive







Re: Almost Diagnosed?

Update after 5 months of ADT:
PSA is 0.4, T is 32

For the last 2 months, have added dutasteride. So, in effect, on ADT3 for the last 2 months. Still worried about higher levels of T. The doctor does not seem overly concerned.

Is surgical castration an option or just let the T be?

We will meet a radonc next week to decide if and how to administer radiotherapy.

Re: Almost Diagnosed?

Another update.

After a PSA nadir of 0.1 7 months post HT PSA slowly inched up. 0.21 at 9 months and then 0.52 at 13 months and 0.67 at 14 months with an approx DT of 3 months.

When PSA hit 0.67 bicalutamide dose was escalated to 150 mg and also started with metformin XR 500 mg to begin with.

PSA at 15 months in March 2016 dropped slightly to 0.58.

The plan is to continue with Eligard + 150 mg bicalutamide + Dutasteride + metformin until PSA starts to rise again. If PSA crosses ~1.5 the plan is to stop the bicalutamide and add Ketoconazole.

Any suggestions are welcome

AllTime

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