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Advanced prostate tests

Posted 21 Apr 2021 at 10:34

Hi. I am new here and need some help. I was diagnosed in feb 2021 with stage 4 .gleason was 8 psa was 64.8 and it had spread to my ribs and chest and spine one spot each. March 23 had my first 3 month injection of lupron. Doctor then did full blood work april 14. Psa had gone to 57 and my alkaline phosphate level was at 148. My testosterone level was .8

My question is it to early after the injection to see much of a drop in psa and also does the alkaline phosphate level something to be worried about. Also is the testosterone level way to low. I will be starting erleada in the next week along with the lupron. 

Thanks for any help

Posted 21 Apr 2021 at 11:33

Hi Amberdriver

Sorry you are here. My husband was diagnosed in July 2019 with advanced PCa in lymph nodes including distant ones, PSA 287 and Gleason 8. He started hormones immediately and chemo less than a month later. 

Just checked for you and his PSA was down to 37 as he started chemo then carried on going down after each cycle.

I think the downward trend is the main thing. 

Best wishes 

Edited by member 21 Apr 2021 at 11:40  | Reason: Not specified


Posted 21 Apr 2021 at 12:41

Thank you for the response. My psa has only gone from 64 to 57 in 3 weeks after first injection. Don't know if this is normal amount down or not.

Posted 21 Apr 2021 at 13:01

I don't think there is a normal amount. I know you are worried but the downward trend is good.

Other people may have their experiences to share too. 


Posted 21 Apr 2021 at 15:09


Posted 21 Apr 2021 at 18:13

Originally Posted by: Online Community Member
Also is the testosterone level way to low.

No - your testosterone response is excellent - only 3 weeks of HT and you are already almost at castrate level; the idea your onco is aiming for is 0.69 or lower. With a level of 0.8, it means there is still a tiny amount of testosterone for your cancer to feed on; as it drops further, your PSA should fall. 

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

Posted 21 Apr 2021 at 18:16

It was only three weeks between Lupron injection and the PSA test. It takes a while for your body to adjust to the new hormone situation. Testosterone of 0.8 is more or less castrate level so that is good, it probably took a couple of weeks to get that low, so your prostate was probably still active up until a week ago. 

So in short I wouldn't worry, PSA is on the way down. 


Posted 21 Apr 2021 at 18:18

Thanks. Was not sure if the psa should have come down a little more. Also was worried about the alkaline phosphate level. 148 seems high.

Posted 21 Apr 2021 at 18:19

Thanks. Start erleada soon. So that should help.

Posted 21 Apr 2021 at 18:27

I just googled Alkaline Phosphate, I have heard of it before but not something I have paid much attention to. It ways normal range is 20-140 so yes you are a tiny bit over. I know some of my blood results are at the top or bottom of the range. I think it is probably best just keep an eye on it. If you keep bobbing along near the top don't worry if it shoots up then yes start asking questions.


Posted 21 Apr 2021 at 18:30


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