Couple of questions seeking advice. I was a G8 at time of Dx so not surprised that surgery failed, SRT failed, and now I have what I believe to be a rapidly rising PSA. I get tested monthly and for the past several months it has been rising about
a tenth of a point each month. I’m now at 0.6 and my Uro is telling me I should start ADT even though he previously told me to hold off until my PSA got to like 10 or 15. Now he says that’s true for patients with slowly rising PSA but with my current velocity the game changes. So for those of you who have experienced a similar situation, when is the right time to start? I know this is a time limited treatment to slow progression and can’t say I’m excited about
the prospect of side effects and would hate to pull that trigger too soon....or too late.
I also discussed the possibility of using Zytiga or Xandi with ADT but he isn’t a fan of that. I blanked out at the name of the study I had read and was trying to tell him about
(Stampede) but wouldn’t it be wiser to go that route given my history, PSA velocity, likely aggressive PCa with the hope that both together would give me a better chance of CR longer than ADT alone? Long story short, my Uro basically fired me after that discussion indicating that he can’t meet my expectations for treatment since they only deal with this one way...ADT alone. Other than that option, he suggested I go elsewhere if I want “experimental” treatment.
I also have an MO in the wings but he usually deals with guys whose ADT has already failed, although he is aware of the Stampede study and we have discussed the pros and cons of the various options. Last we met, the MO was not recommending that I start treatment yet but wants me to make the call as to when to start.
So, I am very uncertain as to what to do and when? Any advice would be most welcome. My stats are in my sig if that helps any.
Age @ Dx: 53- G-8(4+4) PSA: 3.5 5/2011 ORP, pT3a N0MX, EPE, +PNI, +margin, -SVI ED. PSA:6/2011 through 3/2016 all <0.1. PSA 7/12/16: 0.1. uPSA 8/16: 0.149. SRT 9/16 -IMRT 38 @ 68.4 Gy Post SRT uPSA 2/17: .048. 3/17:.037 6/17:.047 7/17.059, 12/17 .042. 1/18 .054. 5/18 0.150 5/18 0.2. 6/18 0.2 7/18 0.2 8/18 0.2. 9/18 uPSA 0.179. 12/18. 0.261. 1/19 0.3 2/19 0.4 4/19 0.5 uPSA 5/19 0.509 7/19 0.6
Post Edited (rcroller) : 7/27/2019 7:47:37 AM (GMT-6)