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First post zoladex PSA result worry !

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User
Posted 11 Aug 2024 at 21:50

OK I’m anxious after a year of calm positivity!

 

I had 19 months of Zoladex and RT for localised G9 (PSA highest 8.5). With a stable PSA of 0.01 at 12 weeks since the RT ended and  my testosterone 0.5 for the last year. 

 

 My first PSA after the zoladex effects expired came back at 0.03 and my testosterone 0.8 (admittedly taken at 4pm in the day). I know ‘intellectually’ that it is still low AND could be normal prostate cells waking up (or less likely, but possibly a lab  fluctuation). However my previous experience of things being missed or under played have made me particularly cautious and anxious (I was initially discouraged from taking a annual PSA test by my physician as ‘it will just worry you’ - lucky I ignored that advice!) 

 

My oncologist told me not to bother with anything until it reached 2 - but again my reaction is slightly more interventionist. I guess I will push for a repeat test in 4 weeks as my scientific background likes all the evidence it can get - of course the anxious prostate patient in me is a whole other entity which sees this as an early confirmation of BCR. 

 

What are others experiences of the first post LHRH agonist PSA & testosterone results and their reactions? 

 

User
Posted 12 Aug 2024 at 01:40

Well my lab only test to 0.1 so all your results would just come to me as <0.1 which is very acceptable. As it happens my results have occasionally been as high as 0.2 which is nearly 10 times your current level and still only 10% of what would be considered a worrying level. So if I were you I would not be worried in the slightest.

Dave

User
Posted 12 Aug 2024 at 07:42

Your PSA is expected to rise as your Testosterone returns if you still have your prostate, so it's good that they're measuring your Testosterone too, so you can make sense of your PSA in the light of Testosterone returning. However, the changes you're seeing at the moment are probably just noise, as your Testosterone, even though it's risen a tiny amount, is still at castration levels.

User
Posted 12 Aug 2024 at 09:50

I am hoping that’s what it is - just noise or lab variance reporting. It’s just that it was reported at 0.01 consistently at 3 month intervals since the end of radiation therapy. so bit odd as you long out my testosterone is still very low and technically still castration level. 

I am just very wary of going with ‘its fine’ or it’s fine u til it’s 2 above nadir - I had that with both diagnosis, to various treatment options which turn out to be less than informed - fortunately I worked  in geriatric medicine in my training as a psychologist and then one of my specialist areas was pyschosexual issues and came into contact with men with  PCa. Of course knowledge is not always a positive when it’s me that is the patient! lol 

 

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User
Posted 12 Aug 2024 at 01:40

Well my lab only test to 0.1 so all your results would just come to me as <0.1 which is very acceptable. As it happens my results have occasionally been as high as 0.2 which is nearly 10 times your current level and still only 10% of what would be considered a worrying level. So if I were you I would not be worried in the slightest.

Dave

User
Posted 12 Aug 2024 at 07:42

Your PSA is expected to rise as your Testosterone returns if you still have your prostate, so it's good that they're measuring your Testosterone too, so you can make sense of your PSA in the light of Testosterone returning. However, the changes you're seeing at the moment are probably just noise, as your Testosterone, even though it's risen a tiny amount, is still at castration levels.

User
Posted 12 Aug 2024 at 09:50

I am hoping that’s what it is - just noise or lab variance reporting. It’s just that it was reported at 0.01 consistently at 3 month intervals since the end of radiation therapy. so bit odd as you long out my testosterone is still very low and technically still castration level. 

I am just very wary of going with ‘its fine’ or it’s fine u til it’s 2 above nadir - I had that with both diagnosis, to various treatment options which turn out to be less than informed - fortunately I worked  in geriatric medicine in my training as a psychologist and then one of my specialist areas was pyschosexual issues and came into contact with men with  PCa. Of course knowledge is not always a positive when it’s me that is the patient! lol 

 

User
Posted 12 Aug 2024 at 23:26

As another set of figures for comparison, a year after the effects of Zoladex had worn off my psa was 0.02 and testosterone 18.4.

My oncologist is happy and I'm ok with the numbers. I wonder if there's a difference between those of us who've had brachytherapy and others, like myself, who had EBRT only.

Jules

 
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