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PSA variance while receiving Degerelix

User
Posted 13 Nov 2024 at 17:19

Hi everyone, 

Hope you are all having a good week. I was just hoping to ask for a little bit of advice for my father. I've posted previously and everyone was so helpful, so I hope I am not monopolising the conversation!

Just to overview the situation - My (80 year old) father's prostate cancer returned earlier this year after successful radiotherapy treatment many years ago. His PSA count was over 5,000 (approximately 3 months ago) and on investigation he has multiple, extensive sclerotic bone metastasis across the torso skeleton, while the worst is in his left leg. We have been advised he is too frail for chemotherapy or surgery to help prevent fractures. He's taking daily Oxycodone.

He was put onto a course of Degerelix - we're a little over half way through now. PSA tests haven't been super frequent, but shortly after treatment started, his PSA count had fallen to around 600. A few more doses and he was down to the 300s. 

He requested a new PSA test this week as his next scheduled one wasn't until December and, after some haranging, received one. His latest reading is 1,115. We were told to expect some variance and not over-focus on individual tests, but rather the long term trend. However, a quadruple of PSA in a relatively short space of time has caused a bit of alarm.

Does anyone have any advise on whether this level of variance is to be expected? We're just trying to figure out whether to try to push for his next urology appointment to be brought forward.

Thanks so much in advance!

 

User
Posted 13 Nov 2024 at 17:19

Hi everyone, 

Hope you are all having a good week. I was just hoping to ask for a little bit of advice for my father. I've posted previously and everyone was so helpful, so I hope I am not monopolising the conversation!

Just to overview the situation - My (80 year old) father's prostate cancer returned earlier this year after successful radiotherapy treatment many years ago. His PSA count was over 5,000 (approximately 3 months ago) and on investigation he has multiple, extensive sclerotic bone metastasis across the torso skeleton, while the worst is in his left leg. We have been advised he is too frail for chemotherapy or surgery to help prevent fractures. He's taking daily Oxycodone.

He was put onto a course of Degerelix - we're a little over half way through now. PSA tests haven't been super frequent, but shortly after treatment started, his PSA count had fallen to around 600. A few more doses and he was down to the 300s. 

He requested a new PSA test this week as his next scheduled one wasn't until December and, after some haranging, received one. His latest reading is 1,115. We were told to expect some variance and not over-focus on individual tests, but rather the long term trend. However, a quadruple of PSA in a relatively short space of time has caused a bit of alarm.

Does anyone have any advise on whether this level of variance is to be expected? We're just trying to figure out whether to try to push for his next urology appointment to be brought forward.

Thanks so much in advance!

 

User
Posted 14 Nov 2024 at 01:16

This suggests he's become castrate resistant, i.e. the Degarelix isn't controlling his cancer. They will probably add another hormone therapy medication. It might also be useful to get a Testosterone level test, just to make sure the Degarelix is suppressing it down to the intended level.

I don't know what you mean by "half way through". The Degarelix (or other equivalent drug) is for life in this case.

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User
Posted 14 Nov 2024 at 01:16

This suggests he's become castrate resistant, i.e. the Degarelix isn't controlling his cancer. They will probably add another hormone therapy medication. It might also be useful to get a Testosterone level test, just to make sure the Degarelix is suppressing it down to the intended level.

I don't know what you mean by "half way through". The Degarelix (or other equivalent drug) is for life in this case.

User
Posted 14 Nov 2024 at 10:08

Hi Andy, 

Thanks for your reply, that's really useful to know! Much appreciated. I'll enquire about the testosterone lest!

Apologies re: the "half way through" comment; I should have clarified that it's half way through the initial treatment period before they have another MDT meeting to discuss his progress and assess options.

Thanks again

 
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