psa rise on lupron

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Regular Member

Date Joined May 2009
Total Posts : 85
   Posted 10/25/2009 10:07 PM (GMT -6)   
Has anyone out there had this situation? psa 107 , gleason 8. April 2007 Started on Lupron(every 4 months, casodex for 2 months. Radiation Oct 2007. PSA decreased to .3 than in april 09 psa started to rise to 3.1 started on casodex , psa fell to 1.5 by August. will see oncologist again in Dec. Why would my psa rise and than drop with casodex. Does it mean the radiation didn't work? Asked my oncologist and he really didn't give me an answer.
AGe 54 diagnosed March of 2007
PSA 107
Gleason 8
Stage T2 or T3 (weren't sure was out of prostate capsule)
Bone scan march 2007 and Aug 2008 both clear
ct 2007 clear
started casadex/lupron March of 2007 (casadex only for 4 months)(lupron for 2 yrs)
Aug 2007 had 37 treatments (also radiated lymph nodes)
psa spr 07-107,went down to .34 by Dec 08, March 09 0.7, May 1.54

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4237
   Posted 10/25/2009 11:06 PM (GMT -6)   
A reoccurrance after radiation is defined as 3 consecutive rises in psa. If psa does not fall to under .05 on Lupron or Casodex it means that there is a high population of androgen independent PC cells vs androgen dependent cells. (the casodex and lupron only work on the androgen dependent cells and the androgen independent cells keep growing.) I would get a 2nd opinion from another oncologist that specialized in only prostate cancer.
With a psa of 107, a G8, and if they radiated the lymphnodes it is highly likely that it was not contained in your prostate. Your doctors should be communicating more with you about your status and it seems they are not. You have the right to answers.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 10/26/2009 12:52 AM (GMT -6)   
Casodex is an anti-androgen. It works at the cell level and prevents the cell receptors from attaching themselves to testosterone or dihydrotestosterone. The Lupron prevents the bodies production of these androgens, but not fully. So what little is there is allowing the cancer to grow. The anti-androgen, Casodex, is working, but it won't forever. Still, varying the combinations can bring the PSA back down. If the Casodex stops working, then Nilandron or Keto could be a next step, and the Casodex can later be re-attempted. Stay positive and hopeful. Many things to try still...

Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at:

My InfoLink page is at Tony's Prostate Cancer InfoLink Page


Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 10/29/2009 8:24 PM (GMT -6)   
I have been gone for a few days and missed this post. Kak I am sorry you are dealing with this situation. John T and Tony offer some expert knowledge and i would encourage to heed the wisdom. My little tidbit to offer is to stay positive and vigilante in the battle. There are still plenty of weapons to fight with. Keep me posted on how you are doing my friend.

peace and love
My PSA at diagnosis was 16.3
age 47 (current)

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
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
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

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