Rise in PSA while on Zolodex

User

Posted 11 Apr 2017 at 18:43

Hi Guys

I would be extremely grateful for your help please.

Hugh has been so lucky to respond to Zolodex for such a long time but his last few blood test results have shown a slow increase in his PSA until his result in March which, although is still very low (0.19), has increased by 58% since December.

He is currently still on monthly Zolodex injections and he's waiting for an appointment to discuss his options.

What is the standard course of action nowadays please - in these circumstances?

Many thanks

Carole

User

Posted 12 Apr 2017 at 00:02

Hi Carole

There are lots of people on this site with more knowledge than me, and next steps will depend on what treatments your OH has already has plus what his diagnosis / stats are but generally chemo is the next step (alongside the hormone therapy). The starting point seems to be 6 sessions at 3-week intervals but some men have more. We were very anxious about the impact of chemo on general health and quality of life but in fact it was all very manageable with only a few days in each cycle when my OH felt really rough. If this is the route that your oncologist suggests it;s worth checking out David's thorough review of this treatment. He posts as CoIU_FC - and includes some really funky music recommends!

Hope things go well for you either way.

Cheers

Eleanor

User

Posted 12 Apr 2017 at 00:13

Hi Carole, if it has only increased by 58% in 3 and a bit months the rate of rise is still quite slow so it may be that the advice is stay with the zoladex for now. Did they test his testosterone? If so, do you know what it was?

The common next step would be to add bicalutimide and see how that goes but it does rather depend on what the testosterone is doing. If he is above castrate level then the zoladex isn't quite doing its job and bicalutimide might be exactly the oomph needed. If he is below castrate level, the PSA rise suggests that the cancer has learnt to survive without testosterone in which case chemo, enzalutimide or abiraterone may be next.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 Apr 2017 at 06:39

Hi Eleanor and Lyn

Thank you so much for your replies.

Hugh is going for another blood test today so I will ask him to get his testosterone levels checked. I don't think he has ever had this tested before.

I'll let you know when he gets the results and what the oncologist says.

Kind regards

Carole

User

Posted 13 Apr 2017 at 17:20

Hugh has just got his latest PSA result of 0.18 (just over three weeks ago it was 0.19) which we are very pleased about but don't understand.

His testosterone levels have never been measured before as far as we know but his reading has just come back at <0.4.

We would be very grateful for your views.

Kind regards

Carole

User

Posted 13 Apr 2017 at 20:44

That's two bits of good news ... he is below castrate level (you are aiming for 0.69 or less on HT) and the rate of rise has slowed. It is possible that he just got a bad batch the last time he had his zoladex injection; it is rare but not unheard of. There are a number of reasons for an injection not working; it may not have been stored properly, it could be from a bad batch or the nurse could have administered it incorrectly.

See what the specialist thinks at your next appointment.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 13 Apr 2017 at 21:23

Thank you Lyn - that is encouraging.

He's going to have another check in a month's time so I'll post the results when we get them.

Very, very grateful for your feedback.

Kind regards

Carole

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