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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.