How low will psa go with hormone treatment

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don826
Veteran Member


Date Joined May 2008
Total Posts : 783
   Posted 11/15/2008 6:55 PM (GMT -7)   
To All,
 
How low will PSA go during hormone treatment? How long does it take? Any experience to share?
 
Thanks in advance,
Don
Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


taiping
Regular Member


Date Joined Apr 2008
Total Posts : 62
   Posted 11/16/2008 12:51 AM (GMT -7)   

Hello Don,

Naturally, everyone is different, but even without radiation therapy the PSA can go very low. After 1-year of hormone therapy alone using Zoladex, Casodex (150 mg/day), and Avodart, my PSA fell from 19.6 to 0.02. After 15-months (last three without any medication except Avodart or Proscar) my PSA is 0.01. I expect the PSA will soon start to go up without hormone therapy, and I will see how far and how fast it will rise.

taiping


Diagnosed: June 2007. Aged 61. PSA 19.6. DRE negative.
Biopsy: June 2007; 2 cores of 18 positive.
MRI and Bone Scan: Negative.
Pathology: 5% of 1 core, "Small focus" in another core +ve.
Gleason 3 + 3 = 6.
Clinical: PCa considered confined to prostate. Stage T1c.
Treatment: After considering RP and HD Brachy, decided on Intermittent Triple Androgen Blockade Therapy for 1-year, using ZOLADEX, CASODEX 150 mg/day, AVODART 0.5 mg/day. Start PSA 19.2 (July 2007).
Completed Intermittent TAB on 23 July 2008, continue with AVODART alone and monitor PSA every 3-months. Changed to PROSCAR in Sept 2008.
Current Status: PSA = 0.01 (October 2008).
PSA nadir 0.01 (October 2008).
---------------


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 11/16/2008 8:42 AM (GMT -7)   
Good morning Don, from my experience with hormone therapy it took a few months to get to a zero. I started out at 16.3 and before radiation I got my first round of Lupron, when I was tested after three months it feel to 1.7, finally after a year it feel to 0.04. The key is that it is consistently falling. The bad thing when you are on hormone is when it starts rising. Hopefully that will be years away. I go back to The Cancer Treatment Center of America Dec 15 for scans and another check up. My goal is to stay a member of the zero club for along time.
Please stay in touch and email me if you would like to chat away from the forum

peace and grace
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
cancer in 4 of 6 cores
92%
80%
37%
28%
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 783
   Posted 11/16/2008 9:07 AM (GMT -7)   
Hi Taiping and Dale,

Thanks for the quick replies. I was just wondering about this subject and was not having much success with my research on it. I had a test that does not show in my signature on Oct 17, 2008 and it was .642. So, I was curious about just how low and how fast the PSA would react. I feel a bit more reassured by your stories. My oncologist has said that he would be happy with anything below a 1 as long as it was steady.

Dale, here's hoping your December results are good.

Thanks again to both of you,
Don
Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 11/16/2008 9:15 AM (GMT -7)   
Don, what side effects have you had from Lupron and Casodex?


Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
cancer in 4 of 6 cores
92%
80%
37%
28%
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 783
   Posted 11/16/2008 9:24 AM (GMT -7)   
Hi Dale,

I think I have had all the "textbook" side effects as follows:

Hot flashes (my favorite)
Loss of body hair (so far no impact on what's left on my noggin)
No libido (still appreciate a nice looking woman just not inclined to pursue)
Shrinking testicles (most sites did not mention this one and maybe it is my imagination)
Weight gain (I had lost 20 LBS just prior to my diagnosis through exercise and now have put back on 17 of them. Trying to work them back off now that radiation is done)

I have not suffered from the depression that others have mentioned. I think that may be partly due to my optimistic nature. Nor have I had any decline (at least that I have noticed) in my cognitive ability. I have been taking some technical courses throughout my treatment and have done OK in them.

Take care,
Don
Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 11/16/2008 10:44 AM (GMT -7)   
My father's PSA was .05 after his RP, however, because of his lymph node involvement, HT was recommended. His PSA fell after three months, but that was also after his radiation. So, my hope is that the radiation killed any remaining cells and he is cancer free. Regardless, his PSA went to undetectable after 3 months. It sounds like your situation is similar and I will hope and pray that the IMRT and HT will kill any cancer cells left. A local radiation oncologist informed my husband and I that his father had PC with pelvic lymph node involvement and that was 14 years ago and he is undetectable today. I keep reminding myself of that story.

Regarding my father's side effects:

Hot flashes are the worst
Loss of libido
Hair loss on the body
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


don826
Veteran Member


Date Joined May 2008
Total Posts : 783
   Posted 11/17/2008 8:23 AM (GMT -7)   

Hi DD,

Thanks for the info on your Dad. It was suggested to me that I should find out why my PSA was not lower after six months of Lupron. I am planning on talking to the urologist this week about it.

Thanks again to all who replied.

Don


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7715
   Posted 11/17/2008 11:02 AM (GMT -7)   
Don,
You have described each of my side effects well. My PSA is not detectable but the SE's are. It took a year but I also had a bout with depression over the summer though I feel it was simply magnification of the loss of a close family member. Otherwise I am a very positive person by nature. A think a big warning label on my Lupron depot is beware of "emotional swings". After 18 months on Lupron my testicles have indeed shrunk but the good news is my jeans fit better ~ :-) .

If you don't get to an undetectable in the next tests you might want to ask your doctor about adding Avodart or Proscar to the mix. He may or may not agree, but it's highly touted by Snuffy Myers and Bob Leibowitz, and I think Strum as well. Maybe just ask for it and see if it get's you there. Also, your radiation treatment may help in the coming months too. Stay well.

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 783
   Posted 11/17/2008 5:26 PM (GMT -7)   

Hi Tony,

The oncologist had mentioned Avodart some time back and had recommended a wait and see approach. He is aware that I am footing the bill on my own for this. I will ask about it on my next PSA depending on the results.

By the way I don't think I have ever had a problem with my jeans fitting. :-)

Take care,

Don


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 

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