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12 years after prostatectomy and radiotherapy PSA has risen to 8.2

User
Posted 25 Mar 2022 at 10:34
Actually I need to correct my quote quality should win over quantity however old you are. All that changes are the thresholds!

As well as Chris there are other examples where PC is discovered late and the HT still works wonders for many years.

Personally I think the fact nothing can be detected AND you are asymptomatic is a reason to delay. Didn't they used to call it watchful waiting? Have they done other bloods etc?

There are a few papers on HT delay and its impact on longevity unfortunately I can't locate them at the moment..

User
Posted 25 Mar 2022 at 16:43

Thanks again Francij and Dave, your posts have certainly given me much food for thought. The main reason I've even been considering HT is for the sake of my wonderful wife. I really do not want to leave her on her own a moment longer than necessary.

 

So it's all about calculating what is the optimum time to opt for HT. Up to now I've been given a strong steer by oncologists that it's when PSA rises to between 10 and 20, with somewhere between 15 and 20 being some kind of watermark after which HT starts to be less effective. The suggestion that this may not be the case is something of a revelation to me, so I will now do a search for the papers on HT delay to find out more. 

 

Interestingly I've just received a letter today from the onco for my next review in July, together with an authority for more bloods prior to that, namely calcium (C4), full blood count, liver function test, PSA and Urea, Electrolytes and creat (U&E) (UE). Prior to this I have only been asked to do a PSA. 

 

Thanks again, your help is very much appreciated.

User
Posted 21 Jul 2022 at 08:31

Argh! The day I've long been dreading has now arrived.

My oncologist phoned to inform me on Monday that my PSA has risen quite sharply, up from 12.2 in March to 17.5 now. Despite this, my latest MRI scan a fortnight ago is still not showing any growths. Nevertheless he strongly urged me to agree to start HT immediately. So, having already read quite widely and anticipated this sort of scenario, as well as discussing it in some depth on here and with close family and friends, I agreed to go ahead and accept his recommendation.

To recap, I was diagnoed with PCa in 2008 and underwent a RP and EBRT in 2009. The last thirteen years have been totally pain free but not without other complications, namely a very over-active bladder and moderate urinary incontinence as well as ED. Over that period my PSA increased slowly at first but then started to accelerate three years ago.

My oncologist informed me that thiis meant I now had a recurrence of the cancer and that it had already escaped the prostate bed, meaning it is now classified as advanced PCa. He suggested that by opting for HT immediately it could be expected to prolong my life for around a further five to seven years from now. However he would not or more likely could not give any indication as to how long I might survive without HT treatment.

I have discussed with the onco previously the option of having another PET scan (the last one in October 2021 revealed nothing significant) but he is of the clear opinion that oligometastisis is very unlikely in my case, therefore in his opinion there is little point in going ahead with another PET scan. He also feels that any delay in commencing HT now could reduce the chances of it being effective.

I face the future with some trepidation but am determined to make the best of every minute of life I have remaining. There is no point in adopting any other approach.

 

 

Edited by member 21 Jul 2022 at 08:37  | Reason: Not specified

User
Posted 21 Jul 2022 at 09:21
What about chemo too then intermittent HT?
User
Posted 21 Jul 2022 at 12:33

Originally Posted by: Online Community Member
What about chemo too then intermittent HT?
Thanks for raising this point. I did ask about chemo alongside, but was told quite simply, no, it's not a course of treatment they were recommending in my case. It was said with some authority so I sensed there was no point in pressing the matter further.

User
Posted 21 Jul 2022 at 12:53
I am surprised that they are not considering chemo. Are you having dual treatment ... hormone therapy (zoladex, prostap or similar) with one of the newer treatments like apalutimide or enzalutimide instead?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Jul 2022 at 13:27
Thankyou for enquiring, Lynn.

H'mm! I was advised to take Bicalutamide f(one tablet once daily) or four weeks and have just taken the first pill today.

After two weeks I will be given an injection at Lister which will be repeated every three months at my local surgery over the next months to a year, when it willl be reviewed.

Providing all is going according to plan, I may then be offered a 12 to 18 month holiday. My oncologist seems very confident that this is the best course of treatment for me.

User
Posted 21 Jul 2022 at 15:19
Ah okay- if a hormone holiday is planned, it would be madness to take enza or apa because when you stop jn a year or so, those options would be forever closed to you.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Jul 2022 at 08:58
Sounds like you have a plan.

May I ask about your rising PSA? When you said it was rising slowly over the last 10 years could you share some figures to show at what rate it was increasing at. I am interested as i am following a similar path

Many thanks

Bri

User
Posted 22 Jul 2022 at 11:17

Originally Posted by: Online Community Member
Sounds like you have a plan.

May I ask about your rising PSA? When you said it was rising slowly over the last 10 years could you share some figures to show at what rate it was increasing at. I am interested as i am following a similar path
Many thanks
Bri

Hi Brian

Yes, no problem. Have set out my full PSA history on my profile page:

Lifestooshor

Happy to give any more background if it helps.

 

 

User
Posted 11 Oct 2022 at 16:27
Today, having completed my first ten weeks on Decapeptyl, I've just had a phone review with consultant and learned that my PSA has crashed right down from 17.55 to 0.07.

So those pesky hot sweats and all the other side effects have been worth it.

WHOOP !!! WHOOP !!!

User
Posted 11 Oct 2022 at 17:03

Been on decapeptyl for 16 months about to finish soon psa 24.9 down to 0.01 along with radiotherapy things are ok  hopefully psa stays low when I finish  glad you are having a positive outcome too all the best gaz 👍

 
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