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rising psa
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An_242284 posted:
Originally in Feb. 2011, I was diagnosed with a gleason scale of 9 and a psa of 441. It had spread to local lymph nodes & small spot on my hip. In November of last year the spot has not grown and my psa had dropped to 0.7 This is due to the Lupron shots I was receiving & 8 weeks of radiation therapy. Without my knowledge i was switched to Trelstar 3 months ago and my psa has risen to 2.2. I am now back on Lupron and Zometta hoping that my psa will go down again. Has anyone had this experience. What are my chances that the Lupron will bring my psa level down again.
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Fairwind responded:
When hormone treatment stops working, the disease is called hormone refractory prostate cancer .

Are you being treated by a Medical Oncologist who specializes in prostate cancer? If not, you should make an appointment to see one..Also, have your testosterone level checked. If the drug is doing it's job, it should be below 20. Below 10 is better still..Ask about a treatment technique called "Triple Blockade" where 3 different drugs are used to completely block the action of your testosterone..
 
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Basir U Tareen, MD responded:
Checking a PSA and testosterone will tell you if the hormonal treatment is effective. Data would suggest that sooner or later the Lupron (or whatever form of hormonal treatment is given) will fail and the PSA will start to rise. In some men, this happens within a year and in other men with metastatic disease this can happen over the course of several years.

Fortunately, we are in a new era of advanced prostate cancer treatment, especially in patient who are castrate-resistant or "CRPC." (ie, the PSA rises despite Lupron or other hormonal agents)

I would make a point to ask your urologist about a treatment plan for the upcoming years -- "what will we do when the PSA rises despite hormonal therapy?"

Options will include adding oral androgen agents (such as casodex) and down the road treatments such as Sipulceul-T (Provenge), chemotherapy, etc.

Best of luck.


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