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I was treated for prostate cancer 10 years ago with brachy therapy. PSA stayed low for a long time then began to rise about 2 years ago. We used Lupron (1 month then 2 3-month doses over the 7 month period through the end of 2013). PSA stayed low for 15 months, then began to rise (now at 2.1). Now the doctor wants to start another 6 months of Lupron. But I read that the body begins to develop an immunity to hormone therapy and I observe that my PSA drops to .1 after just the first 3 months. So, why not just one 3-month shot and wait until the PSA rises again. I can't find any research on how this initial 6 month protocol was developed. Is it based on clinical studies or what? Thanks.
There is a lot of variation in treatment periods by the medical community. I would suspect that you are being treated by a Urologist. I think you should see a medical Oncologist specializing in PC. The short term protocol you are on makes no sense to me. If you were to see a medical Oncologist they would typically have you go 12-13 months and would add cassodex and possibly avadart to the treatment. You don't start shrinking the tumor until you hit your nadir and that usually takes about 3 months.
Regarding resistance, you can normally have 4-7 cycles of hormone therapy before you become castrate resistant. Your Doc should be measuring your Testosterone to make sure it is going below 50 when on treatment.
Normal prostate cells require androgen to function, and prostate cells which mutate to become malignant also require androgen support initially. The TUMOR may or may not mutate so as to be able to grow without androgen support. Whether or not such a mutation occurs is, I believe, a matter of chance, not predictable.
So it is not a matter of your body developing immunity to the hormone, but of the TUMOR evolving the ability to grow without the hormone, which may or may not occur.
