Am I being stupid?

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IDguy55
Regular Member


Date Joined Mar 2010
Total Posts : 27
   Posted 8/25/2010 11:18 PM (GMT -6)   
Got my latest (every 3 months) PSA test Monday and It's back up to .908, from .016 in May. The Doc wanted to give me another dose of Zoladex but I told him that i wanted to wait till my next test scheduled for December 1st. Doc said it would probably be OK being as the .908 was still very low and the Zoladex seemed to work really well in my case. My wife seems to be supportive though she says I can always get the shot any time.

So am I doing myself any harm by delaying the HT shot? I fully expect my PSA will go to 3.5 to 4 by December. But in reading Dr. Strom's book, he gives the idea that a PSA of 5 before restarting HT is acceptable. Or am I missing something?

I do have an appointment on September 7 with an Oncologist who somewhat specializes in PC. Just going to get a 2nd opinion on treatment options. Sounds like I'm rambling on but for the first time since this started almost 5 years ago I feel more confused about what to do. But HT does tend to cause a little confusion.

All the Best to All!

Dallan
Current Age 55, DX October 2005 PSA 50
Biopsy 11/15/2005 Gleason 4 + 3, High Grade PIN, Perineural Invasion, T2 NX MX Stage 2
Bone Scan Clear, CT Scan Negative
open RRP on 12/19/2005 Gleason changed to 3 + 4, Tumor estimated at 25% of prostate volume, Negative Margins,
Extensive Perineural Invasion, Lymph Nodes Clear, Catheter removed 1/3/2006 (holidays) Dry at night. moderate incontinence during the day.
1/25/2006 PSA .046, Moderate Incontinence
2/28/2006 PSA .027
6/22/2006 PSA .043 Just a little stress incontinence
9/08/2006 PSA .065
IMRT Start 10/12/2006 45 treatments 80 gy
1/4/2007 Almost Total Urinary Blockage, Cystoscopy performed, The next few days I had the Urinary tract of a teenager.
1/8/2007 Clogged up again, Catheter put back in. Removed myself (highly recommended) 7 days later No problems since with only occasional very mild stess incontinence since.
1/11/2007 PSA .03
7/26/2007 PSA .011
1/24/2008 PSA .027
5/22/2008 PSA .104
9/25/2008 PSA .383
2/17/2009 PSA 1.06
5/12/2009 PSA 1.5
8/25/2009 PSA 3.8 LHRH agonist (3 month Zoladex) started
11/24/2009 PSA .021
2/23/2010 PSA 0.99 another 3 month Zoladex
5/25/2010 PSA .016, T level 17

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/26/2010 6:59 AM (GMT -6)   
Probably not insane other docs say similar things about resuming hormone therapies after being on them a while. Dr. Strum and others say such things when in proper context. Here is what my radiologist mentioned and he 'says' he has published some things on hormone therapy at PubMed I need to find out the links.

'Psa levels to resume drug therapies in Canada 20.0 or greater (restart)
Psa (USA) pick an arbitrary number between 1 to 10 (restart) 5-10 is ok too
Level of 15 still is considered by many as still sane territory' (may not look sane to us)

Nobody has certainty in this area as to what the biology is exactly like and therefore no real definitive answers to this question. Probably someone whom is non-detectable levels and when going off HT, might consider the lower thresholds for arbitrary resuming, if psa levels rise. This is the assumption from the medical world in general.

Now this is talking about patients whom have done therapies and are recently off cycle or taking a holiday from drugs, and resuming. This is not the case for newly diagnosed people as you want to try to defeat or put into remission all PCa you can and do it asap.

I decided to take a short holiday myself, no drugs thus far for about 1 month, will be getting a PSA real soon and decide. This way you can see your possible velocity and/or or if a doubling time exists...those are things to watch and make decisions upon. If I have only slight rise, then I will go perhaps much further before jumping back in.

Summary- PCa is not an exact science at this time. At psa failure levels one should consider having an oncologist whom understands more about biology of the patient.

Consider this an attempt to answer your question, 'small print' many contain S.W.A.G. information and conflict with your docs opinion, no warranty expressed or implied, results can vary, not valid in Podunk County. (LOL) I didn't stay at a Holiday Inn Express either. This is what I kind of have gathered on this important question.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results

IDguy55
Regular Member


Date Joined Mar 2010
Total Posts : 27
   Posted 8/26/2010 9:46 PM (GMT -6)   
Thanks, Zufus. Thanks for the information about The PSA restart levels... 20 in Canada?? WOW. A friend of my wife told her that I was just conducting a big science experiment , with me as the lab rat

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/27/2010 6:37 AM (GMT -6)   
That was from my radiation doc of whom I found very well versed in PCa, he is well known around this region. So, I presume being close to Canada and he gets around alot almost like free lance at different locations he is working, so should know that first hand.

I know about feeling like a lab rat, I have done few different drugs in this battle. Best to you going forward, you might wish to learn all you can and find PCa has many ways to fight it.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results
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