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Gleason Score 9 PSA 24

Terrified Wife
Posts: 4
Joined: Aug 2018

Help with info on newly diagnosed with PC in May '18.  Husband's PSA is 24 - GS is 9.  Bone Scan and MRI have Stage 4 on them as it has metastisised to the bone/anterial wall of the rectum/seminal visicles/thorasic spine.  Immediatley went on Lupron and Casodex.  One month later PSA dropped to 7!  Additional 6 month Lupron shop, continuing Casodex and added XGEVA shot to build up the bone.  With the dramtic drop in PSA, both oncology and radiation doctor did not recomment treatment at this time.  Help/Normal?


Posts: 700
Joined: Jun 2015

Hi Terrified,

Sorry you had to join our club that no one wants to join.  I guess my next question(s) to your doctors would be "what is the next step".  The anti male hormone shots will knock down the cancer to a certain extent but I feel there will be more treament needed in the future to stop the spread.  Radiation?  more Chemo?  Need to talk to your doctors or get a second opinion for his treatment plan in the future.


Dave 3+4

VascodaGama's picture
Posts: 3387
Joined: Nov 2010


You have posted in another thread that your husband is 60 yo. From the info on the wide spread of the cancer I would think that the whole condition started many years ago. The far metastases at the thoracic vertebrae makes his case difficult to treat with intent of cure. Typically stage 4 patients are treated with chemo and hormonal (ADT) or with these two in combination. Radiation is usually kept to deal with areas causing pain.

You do understand that surgery to remove the prostate gland (you cannot remove whole affected areas) would not alleviate the burden of the cancer but create a series of side effects that surely would deteriorate more his quality of life. Radiation also cannot be administered to the vast areas of the spread. Doctors chose those more critical places applying high radiation doses that kill cancer but this cannot be repeated twice at the same area, which makes them to use radiation to treat only spots of pain.

The good news is about the decrease of the PSA under the hormonal treatment (ADT). It signifies that his cancer is hormone dependent so that it will be possible to hold the bandit during long periods of time, via the vast arsenal of drugs used to treat PCa. There is life after the initial drugs (Casodex and Lupron) with the so called second-line drugs. I recommend you to consult a medical oncologist specialized in prostate cancer. These guys are the ones that know the intrigues of drugs creating a mixture of cocktails to prolong life in advanced cases like that of your husband. Dr. Myers and Dr. Scholz are famous for treating advanced PCa cases but they have retired. Try finding some of their associates. Here is a link to look at;


I believe that his PSA can still go down with added manipulations, using a third blockade with a 5=ARI (5-Alpha Reductase Inhibitor). The dose of the daily Casodex can also be increased (from 50mg to 100mg) which has proven to be effective in lowering the PSA into remission levels. Denosumab (Xgeva) will help in avoiding further deterioration of affected bone but it does not kill cancer. The drug to attack PCa in bone is Xofigo (radium 223) which should not be taken if one's immune system is not in shape.

You should do your own investigations and discuss with his doctor about any particular regarding other health issues that may rise from the treatments. I recommend you to get several tests (total lipids panel, DEXA scan, ECG, Testosterone, Vitamin D, etc) periodically and be vigilant for nay sign. He is young but the medication for cancer will pull him down.

Here are some links that may help you understanding facts;


You can also listen to Dr. Charles “Snuffy” Myers series of past videos with loads of excellent information;


Here are two links on comprehensive introductions on Hormonal Treatment;



An old but still the best book on ADT;

"Beating Prostate Cancer: Hormonal Therapy & Diet," by Dr. Charles Myers

Best wishes and luck in this journey.


Terrified Wife
Posts: 4
Joined: Aug 2018

Thank you so much!


Posts: 39
Joined: Aug 2018

Just wanted to share my support...I'm a terrified wife too.  It sounds like our husbands have similar diagnosis and very similar treatment. My husbands PSA is still high but dropping nicely every month.  Same treatment-Lupron, Casodex and Xgeva.  Luckily very non-invasive treatment and seems to be working.

Certainly a lot to deal with.  We know this is treatable but not curable, but he was diagnosed in Dec and we are coming to grips with a different future than we had anticipated.

Best of luck to you and your family.

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