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psa stays at higher level

tboy
Posts: 2
Joined: Dec 2011

Had Gleason 8 stage 4 131psa in October 2000 had prostectomy in December 2000. Been off and on hormone shots since then. Always reduced psa to lowest level. Had hot flashes etc. Read an article out of Canada in 2001 about finesteride to lessen flashes. Worked well for me. Latest psa I September 2011 was 6.8. Had shot and results today were 6.8. Haven't reached oncologist yet. First time it hasn't gone down in 11 years. What do you think.

VascodaGama's picture
VascodaGama
Posts: 1973
Joined: Nov 2010

Tboy

I wonder what have been your protocol and cycle times on/off drugs. ADT patients experience periods when the drugs do stop their effect. Some become refractory and need to change protocols.
However, it is too early to draw any conclusion in your case, because the PSA has not gone up but kept flat. Laboratory errors could be the cause and so it could a bad shot (no drug or only a fractional portion injected). I would repeat the test and wait for the results.

HRPC is typical in patients on ADT2 or ADT3 (LHRH plus antiandrogen or still added 5-ARI). This is a condition when ARM occurs at cells. The cancer mutates to start feeding on the antiandrogens or starts making its own testosterone. In such cases it is recommended to stop taking the antiandrogens which would show an effective response that can be seen in a drop of PSA. LHRH shots are continued.

In any event, oncologists before classifying/diagnosing someone with HRPC they firstly add an antiandrogen for guys in single ADT (only LHRH shots) or in ADT2/3 increase the drugs potency (50mg to 150mg) or substitute antiandrogens and 5-ARI with others of the same type to certify the diagnosis (ex; Casodex to Cyproterone, etc). Only then they recommend patients to start a second line of hormonal drugs like ketoconazole, etc., or put their patients on a series of targeted drugs such as abiraterone acetate, before starting chemo.

Many other aspects are in play and I would advise you to share more details on your case (chronology of PSAs, symptoms, name of drugs, mg, protocol, etc.).

Wishing you a continuous good journey.

Welcome to the board.

VGama

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