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Intermittent vrs continuous CAB in high risk PSA only recurrence
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cagey8828 posted:
I am a 68 year old who underwent laparoscopic nerve sparing surgery
in Jan 2008. Initial PSA was 4.47 (while on oral finesteride). Pathology revealed positive margin at the bladder neck and minimal microscopic
involvement of one seminal vessicle. Gleason score was 7 (4+3).
One year later PSA increased and I underwent radiation therapy.
In spite of this, PSA rose 10 months later. Doubling time of PSA appeared to be about 3 mo. 0.38, 0.78, 1.44. Combined androgen blockade was started. First PSA was 0.14 and all subsequent tests
are below level of detection (?< 0.10). I am now at 15 months on CAB
and am trying to decide the value/risks of attempting intermittent therapy with CAB. I feel fortunate to have experienced this response.

I am aware of potential benefits but have trouble assessing whether
there is a risk of earlier androgen independence. I would be interested
in hearing professional opinion on this matter. I am aware that there are not prospective studies available to help answer this question..
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cagey8828 responded:
Would love to have a reply
 
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Fairwind replied to cagey8828's response:
Have you read Dr. Pat Walsh's book? Also Stephen Strum's book..They both seem to feel that keeping the cancer cell count as low as possible is more important than giving the patient a brief reprieve from HT...If /when your PSA becomes detectable after CAB is stopped, it can be very difficult to push it down to undetectable again..I am not a doctor and this is just my opinion...For aggressive cancer, you don't just open the cage and invite it out...


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