Rising PSA after 13 months on Zolodex

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Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 9/4/2008 9:55 AM (GMT -6)   
Hi all
 
Had a bit of a shock today as we went to get my husband's PSA result (last one was 4 months ago)
 
It started out at 17.7 then, after starting the Zolodex, went down to 2.3 , 1.1 and then 0.8. We were hoping it would have stayed the same or even dropped slightly.
 
It has gone up to 1.7.
 
The nurse didn't seem too concerned and didn't suggest any change in treatment until the next test in 3 months but we were gutted!!
 
What does this mean? Is the Zolodex no longer working? Has the cancer become hormone refractory or whatever it's called?
 
We feel really unsettled and anxious now and can't bear the thought of a three month wait to find out what's going on
 
Does anyone have any advice or info on our situation?
 
We would be so grateful for any comments
 
Thanks, Julia
Age - 59
Dianosed - July 07
Gleason 8 (4+4)
PSA - 17
Bone Scan - August 07 revealed mets to spine, neck, rib, shoulder and pelvis
MRI - August 07 revealed seminal vesicle involvement
Treatment - Zolodex started on August 10th
First PSA test November 7th - 2.3
Second PSA test February 7th - 1.1
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/4/2008 10:33 AM (GMT -6)   
Julia-
I'm sorry to hear the PSA was not lower. I can imagine so clearly your feeling of being "gutted". I am sure you will get good advice shortly, in the meantime, I wanted you to know that you will be in my thoughts and prayers. Hang in there!
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
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/4/2008 1:34 PM (GMT -6)   
Julia,
You have some challenges ahead, but there is still a lot that can be done to manage this monster. Yes it is likely refractory, but remission is not out of the question. Waiting isn't fun, but necessary. If it is climbing, then Keto, trials, chemo...etc. But at what pace? The next PSA will show a doubling rate. Not sure if you can, but I would request it within a month. Any longer won't tell them anything more. The nurse isn't concerned because it isn't her body. You can put the prpessure on them an when to run more tests. Stay Positive.

In two weeks I get my tests done, too. 16 months on Lupron, I have to have a good test. I give and accept prayers and well wishes...And I'll send some your way.

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, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 9/4/2008 2:32 PM (GMT -6)   

Hi Julia,

First of all sorry to hear such disheartening news. Second, I am not an expert. However, I have done a bit of research in an effort to understand my own situation. You do not indicate what your husband's testosterone level is. My research indicates that <20ng/ml is required for the hormones to be most effective. It is the chemical castration threshold. You may want to have this checked as well as the PSA. It may be that the dosage can be adjusted if the castration level has not been reached.

There is a website with a good bit of information about hormone refractory PCa that you may find worthwhile. The site is

www.hrpca.org.

Take care and best of luck to you and your husband.

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
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.
 
 


DanielleS
Regular Member


Date Joined Jul 2007
Total Posts : 57
   Posted 9/5/2008 10:42 AM (GMT -6)   
I agree that you should not wait three months to test again but insist on testing PSA and testosterone again in a month.  My husband started low dose keto a month ago and has seen a PSA drop so there are other options if the PSA continues to rise.  Don't panic but stay on top of the situation with monthly testing.  Keep us posted.

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 9/5/2008 5:44 PM (GMT -6)   
Sorry to hear about the PSA rise. like Tony said I would encourage you to force the hand of the medical community and get yourself a test sooner than three months. It does look as though it is refractory but the doubling is the key component. There are still options available so please educate yourselves and stay as hopeful and positive as you can. If you would ever like to chat outside of the forum please send me an email.

peace and love
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%
 


Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 9/6/2008 9:26 AM (GMT -6)   

Thank you everyone for your speedy replies and good wishes

The message coming over loud and clear from everyone is that my husband should push for monthly testing. He asked the nurse about that and she said 'it won't make any difference and it'll just make you more anxious (really?? confused  ) but I will put it to the 'team' and let you know'

I don't know why she doesn't think it will make a difference. She was very vague and wishy washy and almost patronising, making out that Rick was a worrier (again, really??)

Don, it was a real coincidence that just before I read your post, I had been on that very website and made a note that Rick should ask about testosterone testing - great minds think alike!!

He has never had his testosterone tested and when he mentioned it to the GP, he went a bit ponderous and said 'now you've got me thinking' I could not believe it. It seems Rick's health is in the hands of well meaning idiots!

Maybe it's because we're in the UK and testosterone isn't routinely tested over here, but it just seems so backwards to me - this is a person's life we're talking about!

Dale, I did say at the time we found out the results that I was concerned that the level had doubled. She replied 'but it's still pretty low' I was thinking 'yes, low for someone not on a drug prescribed to get the level way down but when he's taking Zolodex, it should not be doubling in such a short time. Does that sound right?

I'm pretty sure I come across as Internet 'educated' but to my mind, the treatment Rick is receiving and the response (or rather lack of it!) to the rise in his PSA is making me feel anxious that Rick is getting the best health care

Tony, I am thinking and praying for a good result for you in two weeks

Sending lots of good wishes and thoughts to everyone

Thanks again for responding

Julia xx


Age - 59
Dianosed - July 07
Gleason 8 (4+4)
PSA - 17
Bone Scan - August 07 revealed mets to spine, neck, rib, shoulder and pelvis
MRI - August 07 revealed seminal vesicle involvement
Treatment - Zolodex started on August 10th
First PSA test November 7th - 2.3
Second PSA test February 7th - 1.1
 

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