Radiation with Hormone Therapy-Firmagon

Kongo

RADIATION HOPEFUL said:

Inflamation
Hello VGama

Once again THANK YOU FOR the response.

Today is day 14 after treatment & the burning is subsiding, I don't have any trouble with stools other than a little burning now & then--eating a lot of apple pie keeps things regular & formed well. The urgency to urinate is bothering me especially after I drink fluids. I'm drinking a lot of craneberry juice.
I will be seeing the urologist at the end of the month, perhaps by then I'll be better, I will also get another blood test. I have to see my primary for the complete blood test, the hospital doesn't monitor it after radiation is complete and my urologist has a business office himself away from the hospital staff. I wiil mention the urgency to all three doctors providing it continues. (I did read on the internet it could take a few weeks to months for the burning & urgency to subside ---I was afraid something else was wrong)
Thanks for the reply--I truly appreciate it.

Rad Hopeful

Common Symptom
Hopeful,

As Vasco mentioned, the symptoms you're experiencing are quite common following radiation. Drinking cranberry juice is a smart move as it neutralizes the acid in the urine. Although the urethra is quite tough tissue, radiation sometimes causes temporary inflammation which can be mildly painful and irritating. Besides cranberry juice you may wish to try an OTC anti-inflammatory drug such as Advil which can reduce the inflamed areas, promote quicker healing, and reduce the urgency issues.

I don't think you have anything at all to worry about but please discuss any symptoms with your doctor during your next visit.

In almost every instance, these symptoms subside within a few weeks to a month of treatment.

Best,

K

RADIATION HOPEFUL

Kongo said:

Common Symptom
Hopeful,

As Vasco mentioned, the symptoms you're experiencing are quite common following radiation. Drinking cranberry juice is a smart move as it neutralizes the acid in the urine. Although the urethra is quite tough tissue, radiation sometimes causes temporary inflammation which can be mildly painful and irritating. Besides cranberry juice you may wish to try an OTC anti-inflammatory drug such as Advil which can reduce the inflamed areas, promote quicker healing, and reduce the urgency issues.

I don't think you have anything at all to worry about but please discuss any symptoms with your doctor during your next visit.

In almost every instance, these symptoms subside within a few weeks to a month of treatment.

Best,

K

Common Symptoms
Vasco & Kongo are like having access to doctors ---VERY helpful in decscibing in layman terms answers to many of the posts on this site. I can't speak for everyone but> personally THANK both of them VERY much for sharing their knowledge & answering some difficult questions.
Keep up the excellent work --it is truly appreciated by many.
Thanks for enlightening me about the cranberry juice--I will keep drinking it ( I dilute it with a little water due to the bitter taste. I feel beter after reading these posts.

The urologist called back & is prescribing Procet for the burning. I'm going to try the Advil approach first.

Rad Hopeful

RADIATION HOPEFUL

RADIATION HOPEFUL said:

Common Symptoms
Vasco & Kongo are like having access to doctors ---VERY helpful in decscibing in layman terms answers to many of the posts on this site. I can't speak for everyone but> personally THANK both of them VERY much for sharing their knowledge & answering some difficult questions.
Keep up the excellent work --it is truly appreciated by many.
Thanks for enlightening me about the cranberry juice--I will keep drinking it ( I dilute it with a little water due to the bitter taste. I feel beter after reading these posts.

The urologist called back & is prescribing Procet for the burning. I'm going to try the Advil approach first.

Rad Hopeful

Latest UPDATE APRIL27,2011
AL > Just received my latest PSA report---It continues to go DOWN>>> latest reading is 1.09
last time it was 1.66---a far cry from the original 54.
I assume this is a good sign & I'm elated the trend is still downward. I'm feeling pretty good, working in the yard & the side affects from the radiation are disappearing such as urgency to urinate with burning etc.
"Any comments are welcome"

Rad Hopeful

VascodaGama

RADIATION HOPEFUL said:

Latest UPDATE APRIL27,2011
AL > Just received my latest PSA report---It continues to go DOWN>>> latest reading is 1.09
last time it was 1.66---a far cry from the original 54.
I assume this is a good sign & I'm elated the trend is still downward. I'm feeling pretty good, working in the yard & the side affects from the radiation are disappearing such as urgency to urinate with burning etc.
"Any comments are welcome"

Rad Hopeful

Glad about your symptomless progress
RadHope

Congratulations on your latest results. I am glad to read about your symptomless progress. PSA takes time to get to nadir after radiation. Some guys report taking two years to get to the lowest level. In my case it took 13 months from the end of treatment.
The adjuvant hormonal therapy (firmagon) is relevant in the level of PSA but the RT is the one that have “blown” the cancer.

Wishing you the best.

VGama

RADIATION HOPEFUL

barbercheech said:

radiation treatment
Glad to hear that. i had the same type of radiation treatment.i had 44 treatments plus lupron shots and 2 years later PSA Is Still .005. Reading These Posts Make me Realize how many Guys Are Going Through This With A Lot of Hope And good Results

Please send E-mail
I have a few questions to ask--appreciate it

Rad Hopeful

RADIATION HOPEFUL

VascodaGama said:

Glad about your symptomless progress
RadHope

Congratulations on your latest results. I am glad to read about your symptomless progress. PSA takes time to get to nadir after radiation. Some guys report taking two years to get to the lowest level. In my case it took 13 months from the end of treatment.
The adjuvant hormonal therapy (firmagon) is relevant in the level of PSA but the RT is the one that have “blown” the cancer.

Wishing you the best.

VGama

UPDATE May16,2011
Thanks to everyone answering & following my journey-(especially Kongo & VGama).
Thought I would let everyone know I'm doing very well, with my last PSA at 1.09 & 46 days post radiation treatments I feel good. Yesterday I loaded,unloaded & stacked two tons of pellets (40 lb. bags). I don't get another Firmagon injection until June & will have my PAS checked before that time again.
Bless everyone fighting this terrible disease.

Rad Hopeful

VascodaGama

RADIATION HOPEFUL said:

UPDATE May16,2011
Thanks to everyone answering & following my journey-(especially Kongo & VGama).
Thought I would let everyone know I'm doing very well, with my last PSA at 1.09 & 46 days post radiation treatments I feel good. Yesterday I loaded,unloaded & stacked two tons of pellets (40 lb. bags). I don't get another Firmagon injection until June & will have my PAS checked before that time again.
Bless everyone fighting this terrible disease.

Rad Hopeful

PSA=1.09 is equal to the previous
RadHope
I enjoyed reading your post. PSA=1.09 is equal to the previous but it does not surprises me. You may see fluctuations and "plateaus" along the recovery period before it reaches nadir.
The physical exercises from loading those pellets will help in your recovery.

The best to you.
VG

RADIATION HOPEFUL

VascodaGama said:

PSA=1.09 is equal to the previous
RadHope
I enjoyed reading your post. PSA=1.09 is equal to the previous but it does not surprises me. You may see fluctuations and "plateaus" along the recovery period before it reaches nadir.
The physical exercises from loading those pellets will help in your recovery.

The best to you.
VG

PSA of 1.09
Hello V gama
Sorry if I confused anyone but that was the latest PSa reading from last month, I didn't get tested this month yet. I just wanted to inform all how well I was doing. I will post the next blood test reading when I get it later this month.

Rad Hopeful

RADIATION HOPEFUL

VascodaGama said:

PSA=1.09 is equal to the previous
RadHope
I enjoyed reading your post. PSA=1.09 is equal to the previous but it does not surprises me. You may see fluctuations and "plateaus" along the recovery period before it reaches nadir.
The physical exercises from loading those pellets will help in your recovery.

The best to you.
VG

PSA of 1.09
Hello V gama
Sorry if I confused anyone but that was the latest PSa reading from last month, I didn't get tested this month yet. I just wanted to inform all how well I was doing. I will post the next blood test reading when I get it later this month.

Rad Hopeful

RADIATION HOPEFUL

RADIATION HOPEFUL said:

PSA of 1.09
Hello V gama
Sorry if I confused anyone but that was the latest PSa reading from last month, I didn't get tested this month yet. I just wanted to inform all how well I was doing. I will post the next blood test reading when I get it later this month.

Rad Hopeful

UPDATE ON PSA SCORE
ALL

All following this journey--- (Had my PSA results today & they came back as 0.78)
Also had another shot of Firmagon but the doctor wants me to switch to Eligard.

I'm reluctant to do so based on the side affects I read about on ELIGARD.
GOT a month to think about it---OPen to comments
I'm pleased with the PSA still going down --any thoughts on this milestone?

Bless all
Radiation Hopeful

VascodaGama

RADIATION HOPEFUL said:

UPDATE ON PSA SCORE
ALL

All following this journey--- (Had my PSA results today & they came back as 0.78)
Also had another shot of Firmagon but the doctor wants me to switch to Eligard.

I'm reluctant to do so based on the side affects I read about on ELIGARD.
GOT a month to think about it---OPen to comments
I'm pleased with the PSA still going down --any thoughts on this milestone?

Bless all
Radiation Hopeful

Your results demonstrate that the actual protocol is correct
RadHope

I am very pleased to read about your success. Another lower PSA result, and still more to come. I wonder if you have experienced with certain intensity any symptom in regards to HT. Something that you could relate to; Hot flashes, Fatigue, Decrease in the size of the testes, Dizziness, etc.

I say this because you are reluctant to change Firmagon to Eligard and I cannot understand why your doctor would suggest such a thing when your results demonstrate that the actual protocol is correct.
If your lipids or any other health marker is within the limits particularly the liver health, then I do not see a “clear picture” for the change.

Surely Eligard will also do the job, and its side effects are in fact similar if one compares the results from trials in shots of the same grade (1-month shot), however, medication is metabolized differently in different bodies and that leads to side effects being more acute in some guys than in others.
If you are doing ok with Firmagon I would suggest you to continue on that drug. But, if you cannot alter your doctor’s opinion then try to get the 1-month shot of Eligard which seems to be the one with lesser side effects.
Have a look in this site;
http://www.drugs.com/sfx/firmagon-side-effects.html

The worse side effects actually are due to the low testosterone in our body which both drugs cause equally. The drug itself also have reactions directly affecting our pituitary function such as “pituitary apoplexy”, but that usually is reported from cases using the drug continuously in long periods of time over 4 to 5 years.
You can read about the symptoms here; http://www.medscape.com/viewarticle/518323_6

Your case as I recall, it is for a short period of one to two years, or less if your PSA demonstrates a continuous low plateau.
The only justification logic that your doctor may be thinking is to change due to a practical use of a 6-month shot (like mine) that would avoid your monthly visit to the clinic to have a shot as well as avoid the shot reaction in the skin.

I hope my insight is of help to your decision.
Wishing you the best.
VGama

RADIATION HOPEFUL

VascodaGama said:

Your results demonstrate that the actual protocol is correct
RadHope

I am very pleased to read about your success. Another lower PSA result, and still more to come. I wonder if you have experienced with certain intensity any symptom in regards to HT. Something that you could relate to; Hot flashes, Fatigue, Decrease in the size of the testes, Dizziness, etc.

I say this because you are reluctant to change Firmagon to Eligard and I cannot understand why your doctor would suggest such a thing when your results demonstrate that the actual protocol is correct.
If your lipids or any other health marker is within the limits particularly the liver health, then I do not see a “clear picture” for the change.

Surely Eligard will also do the job, and its side effects are in fact similar if one compares the results from trials in shots of the same grade (1-month shot), however, medication is metabolized differently in different bodies and that leads to side effects being more acute in some guys than in others.
If you are doing ok with Firmagon I would suggest you to continue on that drug. But, if you cannot alter your doctor’s opinion then try to get the 1-month shot of Eligard which seems to be the one with lesser side effects.
Have a look in this site;
http://www.drugs.com/sfx/firmagon-side-effects.html

The worse side effects actually are due to the low testosterone in our body which both drugs cause equally. The drug itself also have reactions directly affecting our pituitary function such as “pituitary apoplexy”, but that usually is reported from cases using the drug continuously in long periods of time over 4 to 5 years.
You can read about the symptoms here; http://www.medscape.com/viewarticle/518323_6

Your case as I recall, it is for a short period of one to two years, or less if your PSA demonstrates a continuous low plateau.
The only justification logic that your doctor may be thinking is to change due to a practical use of a 6-month shot (like mine) that would avoid your monthly visit to the clinic to have a shot as well as avoid the shot reaction in the skin.

I hope my insight is of help to your decision.
Wishing you the best.
VGama

FIRMAGONvs. ELIGARD
Thank you very much for the reply, The most recent shot was given in my stomach by a new technician & she didn't have enough experience in my opinion. She stuck the needle straight into my stomach instead of on a angle then bent it sideways when the PA came in. I also had to tell her to go slow on the serum insertion--some actually ran down my stomach, the needle wasn't tightened to the syringe properly. I'm going to call MOnday & complain about this, I don't ever want her to give me a shot again. I had pain all night & the lump on my stomach is large. All previous shots were done by another tech who did it properly & I never had any pain. I don'y have any dizziness, do experience an occasional hot flash & minor tiredness.The lipids are all within tolerant ranges.
The PA wants me to go to the 4 month shot of ELIGARD due to it being cheaper & my not having to see him but 3 times a year for 3 years. Personally- I'm content with the monthly Firmagon providing it's given properly. Since I have a choice , I'm rather certain I'm going to stay with the FIRMAGON.
AM I at the point of cancer remission? I don't see the radiation oncologist until November of this year. How will I know when I reach NADIR?? Seldom ever see the urologist doctor only the PA(physician ASsistant)
I'm very Happy with the PSA results & appreciate your reply.

Cordially
Rad Hopeful

RADIATION HOPEFUL

VascodaGama said:

Your results demonstrate that the actual protocol is correct
RadHope

I am very pleased to read about your success. Another lower PSA result, and still more to come. I wonder if you have experienced with certain intensity any symptom in regards to HT. Something that you could relate to; Hot flashes, Fatigue, Decrease in the size of the testes, Dizziness, etc.

I say this because you are reluctant to change Firmagon to Eligard and I cannot understand why your doctor would suggest such a thing when your results demonstrate that the actual protocol is correct.
If your lipids or any other health marker is within the limits particularly the liver health, then I do not see a “clear picture” for the change.

Surely Eligard will also do the job, and its side effects are in fact similar if one compares the results from trials in shots of the same grade (1-month shot), however, medication is metabolized differently in different bodies and that leads to side effects being more acute in some guys than in others.
If you are doing ok with Firmagon I would suggest you to continue on that drug. But, if you cannot alter your doctor’s opinion then try to get the 1-month shot of Eligard which seems to be the one with lesser side effects.
Have a look in this site;
http://www.drugs.com/sfx/firmagon-side-effects.html

The worse side effects actually are due to the low testosterone in our body which both drugs cause equally. The drug itself also have reactions directly affecting our pituitary function such as “pituitary apoplexy”, but that usually is reported from cases using the drug continuously in long periods of time over 4 to 5 years.
You can read about the symptoms here; http://www.medscape.com/viewarticle/518323_6

Your case as I recall, it is for a short period of one to two years, or less if your PSA demonstrates a continuous low plateau.
The only justification logic that your doctor may be thinking is to change due to a practical use of a 6-month shot (like mine) that would avoid your monthly visit to the clinic to have a shot as well as avoid the shot reaction in the skin.

I hope my insight is of help to your decision.
Wishing you the best.
VGama

FIRMAGONvs. ELIGARD
Thank you very much for the reply, The most recent shot was given in my stomach by a new technician & she didn't have enough experience in my opinion. She stuck the needle straight into my stomach instead of on a angle then bent it sideways when the PA came in. I also had to tell her to go slow on the serum insertion--some actually ran down my stomach, the needle wasn't tightened to the syringe properly. I'm going to call MOnday & complain about this, I don't ever want her to give me a shot again. I had pain all night & the lump on my stomach is large. All previous shots were done by another tech who did it properly & I never had any pain. I don't have any dizziness, do experience an occasional hot flash & minor tiredness.The lipids are all within tolerant ranges.
The PA wants me to go to the 4 month shot of ELIGARD due to it being cheaper & my not having to see him but 3 times a year for 3 years. Personally- I'm content with the monthly Firmagon providing it's given properly. Since I have a choice , I'm rather certain I'm going to stay with the FIRMAGON.
AM I at the point of cancer remission? I don't see the radiation oncologist until November of this year. How will I know when I reach NADIR?? Seldom ever see the urologist doctor only the PA(physician ASsistant)
I'm very Happy with the PSA results & appreciate your reply.

Cordially
Rad Hopeful

VascodaGama

RADIATION HOPEFUL said:

FIRMAGONvs. ELIGARD
Thank you very much for the reply, The most recent shot was given in my stomach by a new technician & she didn't have enough experience in my opinion. She stuck the needle straight into my stomach instead of on a angle then bent it sideways when the PA came in. I also had to tell her to go slow on the serum insertion--some actually ran down my stomach, the needle wasn't tightened to the syringe properly. I'm going to call MOnday & complain about this, I don't ever want her to give me a shot again. I had pain all night & the lump on my stomach is large. All previous shots were done by another tech who did it properly & I never had any pain. I don't have any dizziness, do experience an occasional hot flash & minor tiredness.The lipids are all within tolerant ranges.
The PA wants me to go to the 4 month shot of ELIGARD due to it being cheaper & my not having to see him but 3 times a year for 3 years. Personally- I'm content with the monthly Firmagon providing it's given properly. Since I have a choice , I'm rather certain I'm going to stay with the FIRMAGON.
AM I at the point of cancer remission? I don't see the radiation oncologist until November of this year. How will I know when I reach NADIR?? Seldom ever see the urologist doctor only the PA(physician ASsistant)
I'm very Happy with the PSA results & appreciate your reply.

Cordially
Rad Hopeful

Expect your PSA to go still much father down
RadHope

Firmagon in the stomach? You mean that she “perforated” the skin and stomach and injected the medicine inside the stomach? Do you really mean that or abdomen?

What an experience you had with that “lady”. I hope the PA has taken notice of the problem and that you get a clear response from them on Monday about the matter. If your doctor is not available then see another one but do not leave the matter unchecked.
I know that agonists should avoid to be injected in veins due to bad reaction.

In my last shot the nurse was new to hormonal depots. She did not know that the two syringes (A with atrigel and B with leuprolide) should be mixed connecting the two syringes and actionating the plunger back and forth about 60 times. I had to instruct her in all the steps. I also had it done in the abdomen without any pain.

I did not know that your protocol is for 3 years. Many guys with similar treatments as yours have HT for periods of 6 to 18 months, and some of them stop HT earlier once the PSA stabilizes. Your doctor may want to have you on a longer period because of your diagnosis prior to treatment. Nevertheless, you have not reached nadir yet.

It is logic that a monthly injection is bothersome if one could avail it of a longer span. Eligard 4-month depot is also friendly when looking into its side effects and you could try with an initial 1-month shot, moving up latter.
If you get nasty symptoms you can go back to the Firmagon again. The medication intent is to keep your testicles “out of service” for a low testosterone level in your body.
The drug has no effect on the cancer itself.

The major side effects for Eligard 4-month shot are described as; hot flashes, fatigue, nausea, joint pain, itching and urinary frequency. Eligard has been friendly to me, being fatigue the most annoying. You can read about it here;
http://www.eligard.com/side-effects/eligard-side-effects.aspx

The point of “Remission” is difficult to define. In another forum I wrote like this:

“Keep a close eye and be prudent in your decisions” may be the best translation for Remission. A number is just another “marker” which does not reflect the whole spectrum of one guys’ status. Remission could be taken with the meaning as absence of symptoms which indicates a successful treatment”.

That said, you are in remission but the success of your treatment can only be certified when your PSA plateaus (stabilizes) and stays there for a long period.

In regards to “Nadir”, you have to be patient and wait for that to come. In my case it occurred 13 months after ending IMRT. I am different than you because I have no prostate, so the curve declines quicker.
In your case under HT after IMRT with a prostate, you will also get a nadir. The difference will be that yours may take longer time to reach. HT can also affect the PSA level (lower PSA) but the number is REAL. A PSA under the influence of HT is not a “faked” value. The important is that the PSA stays continuously low, once the treatment effectiveness ends.
Expect your PSA to go still much father down than 0.78 ng/ml.

I hope you could understand my layman’s explanation.

VGama

RADIATION HOPEFUL

VascodaGama said:

Expect your PSA to go still much father down
RadHope

Firmagon in the stomach? You mean that she “perforated” the skin and stomach and injected the medicine inside the stomach? Do you really mean that or abdomen?

What an experience you had with that “lady”. I hope the PA has taken notice of the problem and that you get a clear response from them on Monday about the matter. If your doctor is not available then see another one but do not leave the matter unchecked.
I know that agonists should avoid to be injected in veins due to bad reaction.

In my last shot the nurse was new to hormonal depots. She did not know that the two syringes (A with atrigel and B with leuprolide) should be mixed connecting the two syringes and actionating the plunger back and forth about 60 times. I had to instruct her in all the steps. I also had it done in the abdomen without any pain.

I did not know that your protocol is for 3 years. Many guys with similar treatments as yours have HT for periods of 6 to 18 months, and some of them stop HT earlier once the PSA stabilizes. Your doctor may want to have you on a longer period because of your diagnosis prior to treatment. Nevertheless, you have not reached nadir yet.

It is logic that a monthly injection is bothersome if one could avail it of a longer span. Eligard 4-month depot is also friendly when looking into its side effects and you could try with an initial 1-month shot, moving up latter.
If you get nasty symptoms you can go back to the Firmagon again. The medication intent is to keep your testicles “out of service” for a low testosterone level in your body.
The drug has no effect on the cancer itself.

The major side effects for Eligard 4-month shot are described as; hot flashes, fatigue, nausea, joint pain, itching and urinary frequency. Eligard has been friendly to me, being fatigue the most annoying. You can read about it here;
http://www.eligard.com/side-effects/eligard-side-effects.aspx

The point of “Remission” is difficult to define. In another forum I wrote like this:

“Keep a close eye and be prudent in your decisions” may be the best translation for Remission. A number is just another “marker” which does not reflect the whole spectrum of one guys’ status. Remission could be taken with the meaning as absence of symptoms which indicates a successful treatment”.

That said, you are in remission but the success of your treatment can only be certified when your PSA plateaus (stabilizes) and stays there for a long period.

In regards to “Nadir”, you have to be patient and wait for that to come. In my case it occurred 13 months after ending IMRT. I am different than you because I have no prostate, so the curve declines quicker.
In your case under HT after IMRT with a prostate, you will also get a nadir. The difference will be that yours may take longer time to reach. HT can also affect the PSA level (lower PSA) but the number is REAL. A PSA under the influence of HT is not a “faked” value. The important is that the PSA stays continuously low, once the treatment effectiveness ends.
Expect your PSA to go still much father down than 0.78 ng/ml.

I hope you could understand my layman’s explanation.

VGama

Injection
V Gama
Thank you for the reply--I truly appreciate it.
The shot was given in the abdomen next to the belly button.
I look forward to reaching Nadir & understand your layman explanation. My radiation treatment ended March30 of this year. (I'm looking forward to stabilization) Is it possible to reach 0.0 PSA if you still have your prostrate?
I'm rather certain I will stay on the monthly Firmagon shots since it is friendly to me when administered properly. (Why change when something is working "OK")
How much lower do you think it's possible to go with PSA readings while taking the hormone drugs?
I appreciate your reply & look forward to a another response.

Cordially
Rad Hopeful

VascodaGama

RADIATION HOPEFUL said:

Injection
V Gama
Thank you for the reply--I truly appreciate it.
The shot was given in the abdomen next to the belly button.
I look forward to reaching Nadir & understand your layman explanation. My radiation treatment ended March30 of this year. (I'm looking forward to stabilization) Is it possible to reach 0.0 PSA if you still have your prostrate?
I'm rather certain I will stay on the monthly Firmagon shots since it is friendly to me when administered properly. (Why change when something is working "OK")
How much lower do you think it's possible to go with PSA readings while taking the hormone drugs?
I appreciate your reply & look forward to a another response.

Cordially
Rad Hopeful

I believe that your nadir will be in the 0.0 range
RadHope

Yes, I believe that your nadir will be in the 0.0 range.
My understanding is that guys on HT only (with the prostate and no other treatment) get to levels of 0.07 to 0.1 when they use an LHRH agonist. If they add an anti-agonist (ADT2) such as Casodex then the PSA goes futher lower to the 0.02 to 0.08 bracket. Guys on ADT3 (triple blockade) with added 5-ARI such as finasteride still go futher to the bracket of <0.01.

Nevertheless you have a challenging case with an initial high PSA on the 53th and Gleason score 9 which may give you a different outcome.
The important is that your PSA keeps stable in a level between 0.05 to 0.15.
You could start a new thread to inquire on the experience of other survivors with similar treatment (IMRT + adjuvant HT), in regards to their nadir PSA and the time it took from the end of IMRT.
Have a look on this guy's story. His PSA went down to 0.01 (http://www.yananow.org/Mentors/AlanJ.htm)

Wishing you the best.
VGama

RADIATION HOPEFUL

VascodaGama said:

I believe that your nadir will be in the 0.0 range
RadHope

Yes, I believe that your nadir will be in the 0.0 range.
My understanding is that guys on HT only (with the prostate and no other treatment) get to levels of 0.07 to 0.1 when they use an LHRH agonist. If they add an anti-agonist (ADT2) such as Casodex then the PSA goes futher lower to the 0.02 to 0.08 bracket. Guys on ADT3 (triple blockade) with added 5-ARI such as finasteride still go futher to the bracket of <0.01.

Nevertheless you have a challenging case with an initial high PSA on the 53th and Gleason score 9 which may give you a different outcome.
The important is that your PSA keeps stable in a level between 0.05 to 0.15.
You could start a new thread to inquire on the experience of other survivors with similar treatment (IMRT + adjuvant HT), in regards to their nadir PSA and the time it took from the end of IMRT.
Have a look on this guy's story. His PSA went down to 0.01 (http://www.yananow.org/Mentors/AlanJ.htm)

Wishing you the best.
VGama</p>

July PSA result
I received my PSA report today & I'm rather upset. IT actually increased to 0.83 from 0.78 & I'm concerned. IS it because of the way the shot was administered last time by a new trainee? Much of the serum ran down my stomach, the needle wasn't tightened & the new tech didn't apply the needle properly at a angle.
Perhaps I'm reading into this too much I don't know but I did expect the PSA to keep going lower. I will see the urologist on Monday the 11th & inform him I will not accept a shot from the new trainee.
I realize it's not much of a rise -- but shouldn't the PSA keep going down?
"Please respond"
Rad Hopeful

VascodaGama

RADIATION HOPEFUL said:

July PSA result
I received my PSA report today & I'm rather upset. IT actually increased to 0.83 from 0.78 & I'm concerned. IS it because of the way the shot was administered last time by a new trainee? Much of the serum ran down my stomach, the needle wasn't tightened & the new tech didn't apply the needle properly at a angle.
Perhaps I'm reading into this too much I don't know but I did expect the PSA to keep going lower. I will see the urologist on Monday the 11th & inform him I will not accept a shot from the new trainee.
I realize it's not much of a rise -- but shouldn't the PSA keep going down?
"Please respond"
Rad Hopeful

Maybe Bounce PSA
RadHope

Do not be upset for the slight increase of PSA. As you commented the cause could have been due to the inappropriate way of the injection but it also could be due to “bounce” which is typical in cases post radiation treatment.
The problematic shot of last month could cause the rise because the quantity of Eligard injected into your belly was not the full dose (your writing; “…Much of the serum ran down my stomach…”). You can check about it with a testosterone test. An increase of PSA in a Low Testosterone status could have a different meaning.
Nevertheless, the increase is not much and you can draw your conclusions in your next PSA checkup.
Just google “PSA Bounce” to read about details of its meaning in the contest of your RT treatment.

I recommend you to check your testosterone levels too, to have it as base data in future.

Regards.
VGama

RADIATION HOPEFUL

VascodaGama said:

Maybe Bounce PSA
RadHope

Do not be upset for the slight increase of PSA. As you commented the cause could have been due to the inappropriate way of the injection but it also could be due to “bounce” which is typical in cases post radiation treatment.
The problematic shot of last month could cause the rise because the quantity of Eligard injected into your belly was not the full dose (your writing; “…Much of the serum ran down my stomach…”). You can check about it with a testosterone test. An increase of PSA in a Low Testosterone status could have a different meaning.
Nevertheless, the increase is not much and you can draw your conclusions in your next PSA checkup.
Just google “PSA Bounce” to read about details of its meaning in the contest of your RT treatment.

I recommend you to check your testosterone levels too, to have it as base data in future.

Regards.
VGama

MAYBE BOUNCE
THANK YOU for the reply.I will follow your recommendations.
I typed in PSA bounce after radiation & was surprised to learn ---many men have a psa bounce after radiation & those who have it under a year of hormone therapy have a much less chance of recurrence. Supposedly the dying cancer cells give off their PSA-- I can only hope this is what happened & the cancer cells are dying.
Again THANKS for the reply --I truly appreciate it.
"Bless you"
Rad Hopeful

Kongo

RADIATION HOPEFUL said:

MAYBE BOUNCE
THANK YOU for the reply.I will follow your recommendations.
I typed in PSA bounce after radiation & was surprised to learn ---many men have a psa bounce after radiation & those who have it under a year of hormone therapy have a much less chance of recurrence. Supposedly the dying cancer cells give off their PSA-- I can only hope this is what happened & the cancer cells are dying.
Again THANKS for the reply --I truly appreciate it.
"Bless you"
Rad Hopeful

Bounce?
Rad Hopeful,

I wonder what your doctor said about the slight increase in the PSA. Bounce is not uncommon for men who have radiation as their only source of treatment but it is much less common in men who are post RP and who have had radiation salvage, particularly when on HT.

It does take a while for the cancer cells to die after treatment--they just don't die when they get zapped--as they need to wait until mitosis tries to occur and then the damaged DNA in the cancer cells can't divide properly and they die. Some scientiests theorize that these dying cells throw off some PSA which causes the bounce but I don't think anyone really knows for sure exactly what causes this. If PSA bounce was caused by cells that were self destructing I think the obvious question is, why doesn't everyone who has radiation get a bounce? Also, the median time for a PSA bounce is about 18 months. You're a bit early for that.

I think a more likely explanation is the botched injection you described which apparently resulted in less of the drug than you should have received. I would be complaining loud and long to the doctor. Interns need to learn, obviously, but they should be very closely supervised.

Best of luck to you,

K