Radiation with Hormone Therapy-Firmagon

Kongo said:

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

muckdown said:

positive feelings
I read your entry and it gives alot of confidence going into adiation treatment

RADIATION HOPEFUL said:

Care
VGama
I asked to have the testerone tested ,the doc never suggested it. I;m also having a echo-cardiogram this Friday. I hve to question fosamax at my next visit. Wonder if taking calcium & magnesium pills help with bone loss.
Your suggstions are all valid & I must be more vigilant in what the urologist is prescribing. At least I got the shot given properly & told the doc I don't ever want the tech who gave the improper shot. Again I only see the PA not the doctor himself.

Thanks for the reply --appreciate it

Rad Hopeful

VascodaGama said:

Successful Numbers


RadHope

Let’s use logic here. Your IMRT ended at Mar30 which makes it just 4 months since your “system” start cleaning up and return to normalcy. This last PSA (under the influence of HT) of 0.8 (Jul30) comes from a high PSA of 4.12 before starting RT and that should give you confidence on the progress of the treatment. It is too early to draw any final conclusion and too early to see a NADIR.
Firmagon effect on the PSA is confirmed by the low level of Testosterone at 20ng/dl.(normal T is over 260). This may be an added fact behind the decrease of the PSA level but the radiation effect on the cancer, which is demonstrated on the decrease of the PSA, is there too, and that comes from a much higher level of 53.99ng/ml at diagnosis.
We see reports on PSA levels decreasing at a much slower pace in cases of IMRT alone. Some of them are reported to take two years before getting to nadir.

You do not need to continue taking monthly PSA tests any more. You can and they are “wonderful” numbers to watch but they serve no purposes in the assessment of your treatment progress from now on. At this 3-month mile-stone post-RT the lower PSA is the first confirmation of success. Let’s hope it continues its “good” path.

I sense anxiety in your sentences;
“…. so I guess I shouldn't get upset. I was hoping for a lower reading but…”

That may be a side effect typical of HT (Firmagon). They come and stay unnoticed until we realize that have fallen into the “trap”.

This monthly post of yours may as well be giving you stress. Surely you are looking for a ZERO and that will come when the time is right. Relax.
My opinion as a comrade on this “boat” of survivors is for you to stop taking those monthly PSA tests and change to PSAs on 3 to 6 month cycles. They are sufficient to inform on any advance in your case.

I sincerely recommend you to go out and enjoy time with your family and friends. Do some travelling and commemorate your 3-month mile-stone success.

I raise a glass of my dearest red wine to celebrate with you.

Regards
VGama

VascodaGama said:

Thanks for the post
RadHope

I hope that you have enjoyed your vacations and that the MONTHLY firmagon has not interfered with your scheduling.

Where did you go? Europe? Portugal?

Glad to know that the PSA keeps the down "trend" path.

Good luck.
VG

VascodaGama said:

Blessed Vacations on God's Country
Nice to know that you have enjoyed your trip to God’s Country. I would like to visit the place too. My vacations are scheduled for a visit to Japan this autumn and surely we will enjoy the peaceful hot springs close to Mont Fuji. (will return to Portugal very “clean”)

Regarding your last results, I take it as the expected trend of the PSA. Most probably you will see still lower numbers followed by a plateau. The PSA is known to be erratic and fluctuates in guys with the prostate gland “in-place”. Your protocol on HT is for two years but I read in some studies that one year on HT have shown identical results.
I wonder what would be your doctor’s answer to the same question.

The important is that after treatment, with HT stoped, the low level (<0.5) is keept. That may occur in two years.

Best regards,
VGama</p>