Checkup Status - Post-Radiation / Existing Hormone - 8/5/2021

13

Comments

  • Josephg
    Josephg Member Posts: 458 Member
    edited May 2020 #42
    81 Month Checkup

    Hi Folks,

    I had my checkup and blood draw for the PSA test last week, and my PSA is currently 0.65, and this is approximately 81 months after my 2nd and final Lupron shot (two 3-month dosages), and also my last salvage radiation treatment (38 visits, 68 Greys).  This test represents the 11th detectible and rising PSA reading in a row, after 30 months of non-detectible readings following the hormone and salvage radiation treatments.

    This most recent PSA test represents a significant jump for me, as my PSA was 0.46 four months ago, and 0.43 four months before that, and 0.41 four months before that.  My Oncologist stated that my current PSA doubling time is approximately 15 months, which is a decrease from my PSA doubling time of 30 months, just 4 months ago.  My Oncologist further advised me, as she does on every visit, that the rate of PSA increase varies, and while this one test shows an acceleration in the rate of increase, the base PSA number 0.65 is still quite low.  My next PSA test will be in 4 months.

    For now, my Oncologist recommends that I stay the course of periodic PSA tests, and when my PSA approaches 2.0, I will receive a Axumin PET scan, to see if the bandit is visible. 

    Again, I want to sincerely thank all of you for your steadfast support, and for the wealth of knowledge and information that you have shared with me on this journey.

    Live life to its fullest, one day at a time.

     

    Related History and Data:

    Post-Robotic Prostate Removal Surgery Pathology Report

    A.  Lymph nodes, right pelvic:  Two (2) lymph nodes; negative for metastasis.

    B.  Lymph nodes, left pelvic:  Two (2) lymph nodes; negative for metastasis.

    C.  Prostate, radical resection:

      1.  Prostatic adenocarcinoma, Gleason grade 4+3=7, involving both lobes, at least 2.1cm and occupying 15% of the prostate by volume.

      2.  No lymphatic/vascular invasion is present.

      3.  Perineural invasion is present.

      4.  Invasive carcinoma focally extends into extraprostatic soft tissue adjacent to the left posterior prostate (C20).

      5.  The Seminal vesicles are free of carcinoma.

      6.  The inked margins are free of carcinoma.

      7.  High-grade PIN is present.

      8.  Necrotizing granulomas are present within the prostate parenchyma; stains for microorganisms will be performed and reported in an addendum.

    D.  Left mid margin:  Fibrovascular tissue; negative for tumor.

    Diagnosis Comment:  AJCC:  pT3a NO

    Da Vinci Robotic Prostate Removal Surgery

    11/21/2011

    AMS 800 Artificial Sphincter Implant Surgery

    1/9/2013 - Original implant

    9/28/2019 - Replacement implant (original implant failed, due to leakage)

    Hormone Therapy (Lupron tri-monthly and Casodex daily)

    Started 5/4/2013

    Stopped 11/6/2013 (2nd and last 3-month dosage shot given on 8/6/2013)

    Radiation Therapy (38 visits, 68 Grays)

    Started 6/4/2013

    Stopped 8/9/2013

    PSA History

    5.22 - 6/28/2011 (59 years old)

    0.05 - 12/22/2011

    0.05 - 3/25/2012

    0.05 - 6/22/2012

    0.06 - 10/13/2012

    0.08 - 12/31/2012

    0.11 - 3/30/2013

    0.13 - 4/23/2013

    0.02 - 8/6/2013

    0.02 - 11/26/2013

    <0.015 - 7/28/2014

    <0.015 - 1/3/2015

    <0.015 - 7/7/2015

    0.02 - 1/15/2016

    0.05 - 8/23/2016

    0.07 - 2/21/2017

    0.10 - 8/22/2017

    0.13 - 12/29/2017

    0.19 - 6/18/2018

    0.26 - 10/15/2018

    0.29 – 2/11/2019

    0.41 - 5/20/2019

    0.43 - 9/13/2019

    0.65 - 1/17/2020

    Related Permanent Side Effects

    Complete Incontinence - Prostate removal surgery (had to remove the left side nerve bundle)

    ED - Prostate removal surgery (had to remove the left side nerve bundle)

    Gynecomastia (benign breast tissue growth) - Hormone treatments of Lupron and/or Casodex

    Hyperhidrosis (excessive sweating every time performing very minor physical activity) - Hormone treatments of Lupron and/or Casodex.

    Hematuria (abundant blood in urine) - Radiation treatments caused recurring instances of bladder wall inflammation.  Biopsy negative.

    Previous Related Posts (Mostly artificial sphincter and hormone/radiation experiences):

    Artificial Sphincter Experiences

    http://csn.cancer.org/comment/1324584#comment-1324584

    http://csn.cancer.org/comment/1326323#comment-1326323

    http://csn.cancer.org/comment/1339326#comment-1339326

    http://csn.cancer.org/comment/1339561#comment-1339561

    http://csn.cancer.org/comment/1344785#comment-1344785

    http://csn.cancer.org/comment/1413239#comment-1413239

    Hormone and Radiation Salvage Treatment Experiences

    http://csn.cancer.org/comment/1414101#comment-1414101

    http://csn.cancer.org/comment/1414282#comment-1414282

    http://csn.cancer.org/node/299431

    Why I joined and participate in this Forum:

    I joined, first, to learn about fellow PCa patients' experiences, as I wanted to gain knowledge of their perspectives and experiences on PCa, related to diagnostics and recommendations, grading parameters, treatment options, and resulting side effects, directly from the patients themselves, after I initially received this perspective from my medical providers.  Having the knowledge of these multiple perspectives and experiences from actual PCa patients was essential to me, in order for me to make my own assessments and decisions, going forward, on how I would approach and plan my journey with PCa.

    I joined, second, because I believe in giving back knowledge and perspective to others, commensurate with receiving them from others.  I have freely shared my experiences related to my journey with PCa, with the understanding that some folks on this Forum may find it useful and beneficial to them in their journeys with PCa.

    And, most important, I continue to strive to gain the most out of my life and those around me, each and every day, as none of us are here in this plane of existence forever.

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited February 2021 #43
    Oligometastatic treatment

    J,

    What you describe above is the concept of the Oligometastatic treatment. I recommend you to discuss with your doctor on the possibility in starting radiation after two month on Eligard. The radiation sodose planning will have in consideration the planning of previous radiated areas. High Gy in fewer number of secctions is common as this time it will be focus in spot radiation (oligo refers to a maximum of five spots).

    In my opinion, Casodex will be enough to do the trick as an antiandrogen. Zytiga is more directed to those that have experienced refractory from other antiandrogens which is not your case at the moment. Apart of that, it is the radiation that kills the bandit. The hormonal component is palliative and it will only help for the success of work of the radiation effect.

    I appreciate that you continue to update us on your journey.

    Best wishes,

    VGama

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #44
    Thank you, Vasco

    Vasco,

    Thank you for your comments and perspective.  As always, they are very much appreciated and valued.

    As you stated, I believe that when I have my consultation with the Radiation Oncologist next week, the recommendation will be to wait a short while before receiving radiation, to allow the hormones soften up the bandit's defenses.

    My chosen cancer institute has been aggressive in attacking the bandit from the beginning of my journey.  After my prostatectomy, when my PSA started rising, they did not wait for my PSA to rise to customary 0.2 threshold before declaring the prostatectomy a failure.  They started my first round of hormone and radiation treatments, as soon as my PSA reached 0.1.  Their actions bought me my first 7 year vacation, that just ended.

    When my PSA started to rise again, they did not wait for my PSA to reach the customary 2.0 threshold to order a PET scan, but instead, they ordered a PET scan as my PSA approached 1.0.  Fortunately for me, they were able to find the bandit in my pelvic bone with the PET scan.

    When they recommended Zytiga in place of Casodex, they advised me that the use of Zytiga will weaken the bandit in more ways than Casodex alone, and potentially improve the desired outcome from the upcoming radiation therapy.  Perhaps their more aggressive approach in my case is directly related to my 4+3 Gleason cancer score, along with other criteria or information that they have.  The good news is that they were able to get me a prescription for Zytiga at a cost of $300 per month, versus $2000+ per month cost through the traditional medical insurance route.

    One day at a time.

  • Josephg
    Josephg Member Posts: 458 Member
    Additional Info to Vasco

    I did mention your comments/questions to my Oncoligist and I received an immediate reply.  She confirmed your supposition regarding my Oligometastatic cancer, and she advised that my current treatment plan is to very aggressively attack/treat the PCa, so that I can have the longest vacation possible, after this current round of hormone and radiation treatments.

    My Oncologist advised that there is significant clinical evidence that the use of Zytiga versus Casodex in conjunction with Lupron/Eligard makes the PCa much more radio-sensitive to the subsequent/concurrent radiation therapy, and has shown much improved outcomes in extending the vacation period.

    As always, I thank you for your thought provoking questions and knowledgeable feedback, and through them, I learn more every time.  And for that, I am very grateful to you.

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited February 2021 #46
    Precaution with drug's interactions

    J,

    Thanks for the info on Zytiga 's benefits. If it is better and affordable then you are the winner. In any case, it may be required that you pair Zytiga with Prednisone which will add more side effects and risks. To such extent, the shorter period on Zytiga the better (say 6 months).  You probably can continue the hormonal period with only the  Eligard agonist, if your doctor sees it required. Prednisone should be phased out (tapering) to allow the body to adjust its cortisol production. I recommend you to get informed on the drug's details. 

    Best wishes for full success 

    VG

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #47
    Prednisone

    You are completely correct, as usual, Vasco.

    I have also been prescribed prednisone to be taken concurrently with Zytiga, and today, I started taking both.  My Oncologist advised that Ztyiga negatively impacts certain critical functions of the body that need to stay in place, and the prednisone reverses the negative impact on these critical body functions.

    I have been instructed to keep a daily log of my blood pressure, which will be reviewed by my Oncologist.  I will also get a complete blood profile test every 6 weeks, where they will be monitoring changes in my liver and kidney functions and enzymes.  They will adjust my current drug regimen, or add additional drugs as needed, to keep my body functions as near to normal as possible, duting this hormone infusion period.

    One day at a time.

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited February 2021 #48
    Oligo treatment

    Joseph,

    I am very interested in this sequential treatment., how it develops and on its ultimate success. The hormonal component is expected to be more noticeable than the previous one of seven years ago because now you can identify each symptom. Even the ones thought to be mild will be more exposed. Try to endure this initial period not giving it much importance. Look for that hobby you enjoy the most to distract you. 

    The old tattoo will provide a more accurate understanding of previous field of attack so that the radiotherapist can plan this time the best direction to deploy the rays. My radiotherapist told me that radiated tissues take at least 5 years to recover meaning that in your 7 years case those radiated areas should be ok by now to absorb radiation but there are always those tissues that did not recuperated totally. Your radiotherapist will avoid those areas as much as possible. 

    I hope it all goes well in your favor. Do not forget in having a testosterone test and the total lipids panel count. Be careful for any anemia.

    Best wishes 

    VG 

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #49
    Thank you, Vasco

    Thank you for your continued interest and support, Vasco.  Very much appreciated.

    You are correct in that I can better 'feel' the emerging side effects of the hormone treatments, given that I have previous experience and knowledge with the side effects associated with these treatments.  I will have to see if the impact of removing Casodex and adding Zytiga and prednisone to the hormone cocktail changes those side effects in any way.  The good news is that I did not really have bad side effects from my previous hormone treatments, certainly not as bad as other folks have reported. 

    I would say that the hormone side effects of 7 years ago were more annoying, than anything else.  At that time, I was still working, and my job was to host and manage business strategy meetings with C-level executives in executive briefings.  One of my most common hormone-related side effects was to sweat profusely, each time that a hot flash occurred.  So, when a hot flash occurred when I was standing in front of these folks leading the discussion in a briefing, my head would start to sweat under my hair and the sweat would start pouring down onto my face from my head.  Also, my wrists would start sweating, and the sweat would start dripping down onto my hands.  As you can imagine, this was quite disconcerting, as most of the attendees were from other companies, and they did not know my personal situation.  I am retired now, so if the profuse sweating starts to occur again during hot flashes, it won't be an issue, as I am home and at leisure.

    My Radiation Oncologist is reviewing the details of my previous radiation treatments, and these details will be incorporated into my upcoming radiation treatment protocol.  My Radiation Oncologist also prescribed an additional drug, Dexamethasone, to be taken before each radiation treatment, to minimize any potential bone pain associated with these radiation treatments.  I found it interesting that when I told them that I am not experiencing any current pain at all in my pelvic bones (I run on a treadmill every two days), they seemed to be surprised.  They then stated that if I am not currently feeling any pain in that area, then the chances are low that I will feel any pain associated with these new radiation treatments.

    Good point on monitoring the testosterone and total lipids panel count.  Part of my treatment protocol is to have a complete blood profile drawn every 6 weeks during my hormone treatments, to observe and track any chemistry changes associated with these hormone treatments.  Also, I was told to take my blood pressure every day (I do not have high blood pressure), and keep a log of it, and to bring this log to every consultation with my Radiation Oncologist.

    As I am typing, I just received my radiation treatment dates from my Radiation Oncologist:  2/17, 2/19, 2/22

    One day at a time.

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #50
    Next Radiation Therapy Plan Developed

    At the recommendation of my Medical Oncologist, I met with a Radiation Oncologist to discuss the next steps in dealing with my PCa recurrence in my left inferior pubic ramus.  She advised me that since the tumor appears to be completely contained within the bone, her recommendation is to attack it with radiation, with the objective of killing it completely.  I had a CT scan and an MRI yesterday, as part of the preparation process for the upcoming radiation therapy.  I will be able to use the same 'locator' tattoos that were placed on me 7 years ago, during my first radiation therapy, which is good news to me (I'm not a fan of needles or tattoos).

    The radiation therapy will be SBRT therapy, using a RapidArc machine, and the radiation will be delivered in 3 doses, delivered every other day.  Each dose will deliver 9-10 grays of radiation, for a total of 27-30 grays of delivered radiation for the 3 doses.

    As an additional note, the side effects of the newly initiated hormone therapy of Eligard, Zytiga, and prednesone are now starting to be felt by me.  Not too bad yet, but it is giving me flashbacks to my first hormone treatments of 7 years ago.

    One day at a time.

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #51
    Update - Vacation Is Over

    Hi Folks,

     

    Summary:

    After a number of sequential rises in my PSA over the past 12 months (0.29 to 0.98), my Oncologist ordered a PET scan with the F-18-fluciclovine radiopharmaceutical.  The results of the PET scan showed a lesion in my left inferior pubic ramus, most likely representing an osseous metastasis.  As a result, my Oncologist recommended that I go back onto Casodex and Lupron for 6 months to 2 years, and simultaneously undergo radiation therapy on the lesion.

    So, my hormone vacation since 2013 is over, and last week I started on Casodex daily pills.  Today, I went for my Lupron injection, and I was told that there is a shortage of Lupron supply.  Instead, I received an injection of Eligard (which is basically the same as Lupron, except that Eligard is a subcutaneous injection, whereas Lupron is an intramuscular injection).

    I meet with a Radiation Oncologist in early February to discuss the recommended radiation therapy.  I know nothing yet about this recommended radiation therapy, except that it will be delivered in a few large doses, versus the 38 small doses that I received on my prostate bed in 2013.

    Also, my Oncologist wants me to switch from Casodex to Zytiga, if we can find an affordable source for this drug.  The market rate for me for Zytiga, after insurance, is $2000-$3000 per month, which is well above what I can afford.  We are currently looking into other funding options, which may bring the cost of Zytiga down to approximately $300 per month, which I can afford.  If the lower cost option is available and confirmed, I will have a subsequent conversation with my Oncologist to better understand the clinical advantages of Zytiga over Casodex.  Then, I will make a decision regarding whether or not the clinical advantages of Zytiga justify the additional cost to me of almost $300 per month (Casodex currently costs me $11 per month, after insurance).

    So, the 'fun' of hormone and radiation therapies begin again for me.  The good news is that my Oncologist believes that I will still be around for a number of years to come.

    Again, I want to sincerely thank all of you for your steadfast support, and for the wealth of knowledge and information that you have shared with me on this journey.

    Live life to its fullest, one day at a time.

     

    Related History and Data:

    Post-Robotic Prostate Removal Surgery Pathology Report

    A.  Lymph nodes, right pelvic:  Two (2) lymph nodes; negative for metastasis.

    B.  Lymph nodes, left pelvic:  Two (2) lymph nodes; negative for metastasis.

    C.  Prostate, radical resection:

      1.  Prostatic adenocarcinoma, Gleason grade 4+3=7, involving both lobes, at least 2.1cm and occupying 15% of the prostate by volume.

      2.  No lymphatic/vascular invasion is present.

      3.  Perineural invasion is present.

      4.  Invasive carcinoma focally extends into extraprostatic soft tissue adjacent to the left posterior prostate (C20).

      5.  The Seminal vesicles are free of carcinoma.

      6.  The inked margins are free of carcinoma.

      7.  High-grade PIN is present.

      8.  Necrotizing granulomas are present within the prostate parenchyma; stains for microorganisms will be performed and reported in an addendum.

    D.  Left mid margin:  Fibrovascular tissue; negative for tumor.

    Diagnosis Comment:  AJCC:  pT3a NO

    Da Vinci Robotic Prostate Removal Surgery

    11/21/2011

    AMS 800 Artificial Sphincter Implant Surgery

    1/9/2013 - Original implant

    9/28/2019 - Replacement implant (original implant failed, due to leakage)

    First Hormone Therapy (Lupron tri-monthly and Casodex daily)

    Started 5/4/2013

    Stopped 11/6/2013 (2nd and last 3-month dosage shot given on 8/6/2013)

    Second Hormone Therapy (Eligard tri-monthly and Casodex daily)

    Started 1/29/2021

    First Radiation Therapy IMRT (38 visits, 68 Grays)

    Started 6/4/2013

    Stopped 8/9/2013

    Second Radiation Therapy SBRT (3 visits, 30 Grays)

    Started 2/17/2021

    Stopped

    PET Scan Report - 1/21/2021

    Technique:  Radiopharmaceutical: F-18-fluciclovine.  Dose: 10.87 mCi.

    Image acquisition:  Approximately 3-5 minutes following IV tracer administration via a right antecubital fossa vein, positron emission tomography was performed from the vertex through the mid thigh. Non-contrast low-dose helical CT imaging was performed over the same range without breath-hold for attenuation correction of PET images and anatomic correlation.

    Results:  There is focal mildly increased radiotracer uptake within a sclerotic lesion in the left inferior pubic ramus, most likely representing an osseous metastasis.

    PSA History

    5.22 - 6/28/2011 (59 years old)

    0.05 - 12/22/2011

    0.05 - 3/25/2012

    0.05 - 6/22/2012

    0.06 - 10/13/2012

    0.08 - 12/31/2012

    0.11 - 3/30/2013

    0.13 - 4/23/2013

    0.02 - 8/6/2013

    0.02 - 11/26/2013

    <0.015 - 7/28/2014

    <0.015 - 1/3/2015

    <0.015 - 7/7/2015

    0.02 - 1/15/2016

    0.05 - 8/23/2016

    0.07 - 2/21/2017

    0.10 - 8/22/2017

    0.13 - 12/29/2017

    0.19 - 6/18/2018

    0.26 - 10/15/2018

    0.29 – 2/11/2019

    0.41 - 5/20/2019

    0.43 - 9/13/2019

    0.46 - 1/17/2020

    0.65 - 5/22/2020

    0.97 - 9/25/2020

    0.98 - 1/11/2021

    Related Permanent Side Effects

    Complete Incontinence - Prostate removal surgery (had to remove the left side nerve bundle)

    ED - Prostate removal surgery (had to remove the left side nerve bundle)

    Gynecomastia (benign breast tissue growth) - Hormone treatments of Lupron and/or Casodex

    Hyperhidrosis (excessive sweating every time performing very minor physical activity) - Hormone treatments of Lupron and/or Casodex.

    Hematuria (abundant blood in urine) - Radiation treatments caused recurring instances of bladder wall inflammation.  Biopsy negative.

    Previous Related Posts (Mostly artificial sphincter and hormone/radiation experiences):

    Artificial Sphincter Experiences

    http://csn.cancer.org/comment/1324584#comment-1324584

    http://csn.cancer.org/comment/1326323#comment-1326323

    http://csn.cancer.org/comment/1339326#comment-1339326

    http://csn.cancer.org/comment/1339561#comment-1339561

    http://csn.cancer.org/comment/1344785#comment-1344785

    http://csn.cancer.org/comment/1413239#comment-1413239

    Hormone and Radiation Salvage Treatment Experiences

    http://csn.cancer.org/comment/1414101#comment-1414101

    http://csn.cancer.org/comment/1414282#comment-1414282

    http://csn.cancer.org/node/299431

    Why I joined and participate in this Forum:

    I joined, first, to learn about fellow PCa patients' experiences, as I wanted to gain knowledge of their perspectives and experiences on PCa, related to diagnostics and recommendations, grading parameters, treatment options, and resulting side effects, directly from the patients themselves, after I initially received this perspective from my medical providers.  Having the knowledge of these multiple perspectives and experiences from actual PCa patients was essential to me, in order for me to make my own assessments and decisions, going forward, on how I would approach and plan my journey with PCa.

    I joined, second, because I believe in giving back knowledge and perspective to others, commensurate with receiving them from others.  I have freely shared my experiences related to my journey with PCa, with the understanding that some folks on this Forum may find it useful and beneficial to them in their journeys with PCa.

    And, most important, I continue to strive to gain the most out of my life and those around me, each and every day, as none of us are here in this plane of existence forever.

     

  • Josephg
    Josephg Member Posts: 458 Member
    edited February 2021 #52
    Radiation Treatments Completed

    I received my 3rd and final SBRT radiation dosage to the identified cancer in my hip bone.  Everything went smoothly, and as planned.  I was also given 5 mg. of Dexamethasone, prior to each radiation treatment.

    I met with my Radiation Oncologist after this final treatment, and she believes that there is a 90+% chance that all of this identified cancer will be killed.  She delivered a total of 30 Grays directly into the identified cancer mass, and delivered 27 Grays to a 1 cm. perimeter around the identified cancer, and delivered 10 Grays to an additional 1 cm. second perimeter around the first perimeter.  The angles of radiation delivery were set in a manner that avoided passing through the previously radiated prostate bed (68 Grays, 7 years ago).  My Radiation Oncologist will prescribe another MRI in a month or so, to obtain an updated baseline for future monitoring. 

    In the meantime, I will remain on the Eligard, Zytiga, and Prednisone hormone cocktail, until my Medical Oncologist takes me off them.  I have a blood draw and chemical profile workup scheduled for early March with my Medical Oncologist, to monitor any potential negative impact of the hormone cocktail on my blood and organs chemistry.

    One day at a time.

  • Old Salt
    Old Salt Member Posts: 1,523 Member
    edited February 2021 #53
    Thanks for the update

    Congratulations on finishing your most recent radiation therapy.

    I hope that the ongoing hormone treatment will result in the death of all circulating tumor cells. 

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited February 2021 #54
    One day at a time

    Yes, one day at a time. I am very glad for reading this update on your smooth therapy. I hope the results reflect success, freeing you from the bandit and from concerned side effects. Thanks for the details on the protocol. I think that Dexamethasone was used to prevent formation of colitis. Your thread is inspiring and will benefit many afflicted with similar situations. Thanks for reporting mate.

    VG

  • Josephg
    Josephg Member Posts: 458 Member
    edited March 2021 #55
    First Post- Radiation Checkup Good

    I had my first post-radiation checkup with my Medical Oncologist.  My PSA has dropped to 0.25 (from 0.98), and all of my blood work chemistry indicators are currently within normal upper and lower control limits.  My Testosterone level is now less than 3.  So far, so good.

    My next visit with my Medical Oncologist is at the end of April for another PSA and blood draw and chemistry evaluation, and to receive my second 3-month Eligard injection.  I also have a visit scheduled with my Radiation Oncologist in late June for an MRI to review the results on my recent SBRT radiation treatment, to establish an updated benchmark of my body images, and to look for any other potential signs of the Bandit hiding in other places.

    One day at a time.

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    Thanks for the update

    You have not commented on symptoms which is a good sign of positiveness. The PSA will drop further but it will gain meaning only after the end of the ADT's effectiveness. Expect it to occur by October.

    Best,

    VG

  • Josephg
    Josephg Member Posts: 458 Member
    edited March 2021 #57
    Symptoms

    Radiation:  I may have experienced some very slight fatigue about 1 week after the radiation treatments completed, but nothing even close to the fatigue that I experienced at about 1 1/2 weeks into the IMRT radiation therapy back in 2013.  I work out with weights and my treadmill every 2 days, and I have experienced some slight fatigue with the weightlifting toward the end of my last set of reps for each weightlifting activity.  I also felt some slight fatigue toward the end of my treadmill jogging session.  However, none of this fatigue was strong enough to stop me from completing all of my weighlifting and treadmill acivities.  Also, it is possible that this slight fatigue may in fact be more related to my hormone cocktail therapy.

    Hormones:  I am experiencing the hot flashes, slight breast sensitivity, and emotional twinges with this hormone cocktail, similar to my previous hormone therapy back in 2013. I have noticed that I also experience some 'chills' at the opposite midpoint of my hot flash cycle, and I do not recall this occuring back in 2013.  So, I am putting on a sweatshirt for the chills, and then 10 minutes later quickly taking it off for the hot flashes.  While this can be somewhat annoying at times (could be an emotional twinge), I really have no serious complaints about the side effects of the hormone therapy, as it is not really negatively impacting my quality of life in any significant manner.

    One day at a time.

  • Josephg
    Josephg Member Posts: 458 Member
    4/28/2021 Status

    Hi Folks,

    I had my 3 month post-SRBT radiation / Eligard/Zytiga/Prednisone hormone cocktail status checkup today, and my Medical Oncologist said that all is going according to plan.  My testosterone is <3 ng/dL, and my PSA has lowered to 0.05.  All of my critical blood chemistry test results are within the control limits.  I also received my 2nd Eligard injection.

    My Medical Oncologist currently believes that I should remain on the Eligard/Zytiga/Prednisone cocktail for a total of 2 years, if I can stand it.  Currently, while I find this cocktail and its side effects somewhat annoying, it does not reduce my quality of life in any significant way, so I am committed to remain on the hormone cocktail for the 2 year period.

    My next checkup with my Medical Oncologist will be in late July, at which time, in addition to testosterone, PSA, and blood chemistry tests and my next Eligard injection, I will also receive a bone density scan to establish a baseline to track future bone density changes, resulting from my continued taking the hormone cocktail.

    I also have a visit scheduled with my Radiation Oncologist for late June to receive an MRI to observe the results of my recent SRBT radiation therapy on my pelvic bone.

    As always, I appreciate the guidance and support that I have received from the members of this Discussion Board, and I wish you all the best of outcomes on your PCa journeys.

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited April 2021 #59
    Kidney matters

    Your update is super. The success of the treatment for this three months period can be judged via the low values of T and PSA. Let's hope for good results in the MRI exam.

    I recommend you to include in the blood work the markers for the kidney function.

    Best,

    VG    

  • Josephg
    Josephg Member Posts: 458 Member
    Kidney Function Markers

    My 4/28/2021 test results for these kidney function markers are listed below:

    Serum Creatinine  1.04  (Standard Range 0.5 - 1.2)

    BUN  16  (Standard Range 6 - 23)

    EGFR  73  (Standard Range >59)

  • Old Salt
    Old Salt Member Posts: 1,523 Member
    Bone density

    Let me emphasize that effects of hormone therapy on bone can be minimized by appropriate exercises. Walking, for instance, is great and good for your heart as well.