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I am 62 years old. I was started on Zoladex in June 2014, because my PSA was 65 and fortunately it had not spread to the bones but was confined to the pelvic area. By December, 2015 my PSA had dropped to 0.01. In June 2016, Zoladex was stopped but I was put on observation. Last December, 2016 my PSA was still 0.01 and I was told to go for review in June 2017 with a new PSA test. Unfortunately, my PSA has gone up to 0.2 this June, 2017, an increase of 20 times. I am feeling alright, but what I noticed of late was an increase in sexual feelings.
I was told Zoladex is only administered for two years, so I am wondering what drug options are available for patients in my situation. Your comment will be most welcome.
It's conceivable that your treating physician has intermittent hormone therapy in mind for you, but it also seems as if you should be better informed about his or her intent.
I would suggest you make an appointment with him or her to find out what the long term plan is for you. Take a trusted friend or relative with you. Both of you should ask questions and take notes.
Few of us fellow PCa warriors would second guess your treating physician at this point, although some of us may suggest consulting another medical oncologist for a "second opinion" depending on how your current physician responds to your inquiries.
Thank you very much Don Oberlin for your inspiring response.
Unfortunately I live in a third world country (in Africa) where choices are very limited - facilities and drugs are mostly donated from developed countries.
At the moment the whole country has only one Cancer Clinic/Hospital (for a population of about 15 million!) with some neighboring countries depending on it as well for their patients.
I can only pray that an alternative treatment regime will be available for me. Of course I will seek answers to my anxieties when I meet my oncologist.
You are most welcome.
The scarcity of drugs in your area probably explains the two year limitation you referred to in your initial posting. Hopefully your oncologist can scout out a suitable alternative or more of the same if indicated when you see him or her next.
BTW The return of your sexual arousal can probably be explained by an increase in your testosterone due to the cessation of the drug you were on.
I met my oncologist on Thursday, 29th June, 2017 who brushed aside my rising PSA as insignificant and inconclusive. He advised me not to worry because of a lot of factors that can lead to rising PSA.
So he just advised me to see him after six months, except that this time, I should take two three-monthly PSA results, that is, one to be taken in September and another one in December this year for comparison purposes. He asked me if I had any complaints to which I said none, and dismissed me accordingly.
FCB - Read your post with interest. You didn't mention if a biopsy was performed or not at this point. The hope is always that a high PSA like you started with is just from some sort of infection and not the dreaded "C" word. Don gave some good input and it sounds like you are paying proper attention to the situation. Now that you are off that drug, the real PSA levels can be monitored and we are all hoping they stabilize from here on. The alarms don't go off till it reaches the area of 4.0 I am told, as anything below that is considered normal for someone with his intact prostate. We all hope you can keep it that way! Jon R.
Dear Jon R and colleagues,
No, the doctor didn't even bother to do any tests or physical exams apart from looking at my current (0.2 PSA) and past PSA history (6 months ago my PSA was 0.01) and asking me how I was feeling. I answered him that I was feeling good, apart from the usual side effects - hot flashes and incontinence, mainly. To him, a rise in PSA from 0.01 to 0.2 in six months was not alarming, and attributed it to a lot of factors, like sex (because of late my sexual feelings have been on the rise, unfortunately!)
A biopsy was only done when the disease was first diagnosed about April, 2014 (PSA was then 65 and had spread outside the capsule but was confined to the soft tissues in the pelvis area only, after an MRI and "nuclear biology" scans revelations)
The only thing the oncologist told me was to take with me this time PSA test results to be done in September and December (that is, 3 months intervals) when I go for review in December, 2017, for comparisons purposes. Previously I was only doing PSA tests every six months, that is, after June, 2016.
Thank you for your support
Thanks Don O, I have just posted the experience I had with my oncologist last June, 2017 when I went for review. I am in a third world country (Africa) so attention to detail may be different from other (developed) parts of the world where facilities are readily available