PSA CONCERN

TODAY I had an appointment with my urologist. My PSA is now down to 0.28, it was 0.30 last month.I asked if there was a chance of cure---the PA immediately said NO--that my PSA should be down to zero by now---after 1 full of year of hormone shots (FIRMAGON) & the radiation protocol I chose. This has been bothering me all day, IS HE (the PA) correct in his answer??

THANKS to all that reply

Radiation Hopeful
«1

Comments

  • laserlight
    laserlight Member Posts: 165
    good evening
    It looks like maybe a talk with the urologist is needed. My doctor always takes time to answer questions completely. I do have contact with the PA but she is real good with communication and also takes time to answer questions. IF this does not work, then maybe another doctor's input will help. I think that the way the PA answered needs to be looked at. The PA's training is complex, but the doctor is the real expert. After 16 months my PSA level is at a 0.03, the doctor explained the it would be nice to see all Zero's, but this does not always happen. Now all I have had has been the surgery. I hope this helps this is just my humble opinion. Fighting cancer sucks, but the PA and doctor owes it to you to answer questions in a professional manner. Donot let this bother you, there are good people here with some very deep insight
  • Kongo
    Kongo Member Posts: 1,166 Member
    Cure?
    Hopeful,

    Forgive me if I have misremembered but I seem to recall that you were initially diagnosed with a Gleason 9 with no evidence of metastasis and your medical team launched you on a course of hormone therapy coupled with IMRT. Wasn't your original PSA reading in the 50s? Now, about 18 months later, your PSA is down to 0.28 and still dropping. I am assuming you are still receiving the Firmagon shots.

    Setting aside the apparent bluntness of this particular PA it seems to me the gist of your question is whether or not a "cure" is in the offing. There have been many discussions in this forum on whether or not there is truly a cure for prostate cancer or any cancer that is inherently metastatic for that matter. It seems that a "cure" is in the eye of the beholder.

    From what I have read in many cases that an early stage prostate cancer completely contained within the prostate gland and treated with either surgery or radiation that there is an excellent chance that the cancer will not manifest itself again. Historically, both surgery and radiation show about a 30-35% chance of biochemical recurrence characterized by rising PSA scores some time after treatment. While some of the more modern forms of radiation (such as what you received) seem to have a much lower recurrence rate in the near term, we won't know for several years whether this trend will continue at the 10 and 15 year points.

    Prostate cancers diagnosed in the intermediate and advanced stages have higher rates of recurrence. A Gleason 9, as you well know, is a dangerous cancer. Although there may not be any immediate evidence of metastasis there is a high likelihood that a Gleason 9 patient will see tumors that have spread outside the prostate via the blood or lymph systems even though they might be microscopic and otherwise undetectable. Your treatment course, which i personally think was very wise on your part, went after the cancer in an aggressive way. The radiation attacked the prostate cancer cells within the target area of the IMRT and the Firmagon works to curb cell growth in those areas that were not radiated.

    The fact that your PSA continues to drop is a good sign in my lay opinion. It suggests to me that your treatment is working as intended. What i suspect that the PA was trying to say is that the Firmagon (or any hormone therapy drug) should knock the PSA levels down to near zero levels regardless of whether or not any other treatment has occurred. I'm certainly no expert on hormone therapy and I don't know what the normal range of expected PSA scores should be given your Gleason 9 starting point. I would request an email exchange or arrange for a telephone chat with your lead physician and ask him what his opinion of a PSA = 0.28 after being on Firmagon for a year really means for a Gleason 9 patient and whether this is within a normal range or not.

    You really won't get a feel for the effectiveness of the radiation treatment until you have stopped hormone therapy and your testosterone leeks return to normal. This could take several months after you stop taking shots.

    Men who retain their prostates will never see a zero PSA score. (Although HT skews this data) Their PSA will decline until a nadir, or low point, is reached, and then stays at that level. If PSA results raise more than 2.0 ng/ml above the nadir it is usually considered a recurrence.

    One phenomena associated with radiation treatment is the PSA bounce effect where the PSA declines after treatment then inexplicably increases and then continues a decline toward nadir. Perhaps your reading was somewhere during the bounce phase? I would also query your doctor about his thoughts on PSA bounce.

    In any event your PSA continues to decline and that is a very good thing from my perspective. Whether or not there is a "cure" seems off point to me. What I think you should be asking is: Is this cancer going to progress to a terminal late stage that kills you? I think its way, way to early to draw that conclusion on that and the PA should have made that clear to you. I wish your PA had taken the time to put all of these numbers and nuances in perspective for you and I hope you seek further clarification with the doctor in person.

    Best to you.

    K
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218
    Kongo said:

    Cure?
    Hopeful,

    Forgive me if I have misremembered but I seem to recall that you were initially diagnosed with a Gleason 9 with no evidence of metastasis and your medical team launched you on a course of hormone therapy coupled with IMRT. Wasn't your original PSA reading in the 50s? Now, about 18 months later, your PSA is down to 0.28 and still dropping. I am assuming you are still receiving the Firmagon shots.

    Setting aside the apparent bluntness of this particular PA it seems to me the gist of your question is whether or not a "cure" is in the offing. There have been many discussions in this forum on whether or not there is truly a cure for prostate cancer or any cancer that is inherently metastatic for that matter. It seems that a "cure" is in the eye of the beholder.

    From what I have read in many cases that an early stage prostate cancer completely contained within the prostate gland and treated with either surgery or radiation that there is an excellent chance that the cancer will not manifest itself again. Historically, both surgery and radiation show about a 30-35% chance of biochemical recurrence characterized by rising PSA scores some time after treatment. While some of the more modern forms of radiation (such as what you received) seem to have a much lower recurrence rate in the near term, we won't know for several years whether this trend will continue at the 10 and 15 year points.

    Prostate cancers diagnosed in the intermediate and advanced stages have higher rates of recurrence. A Gleason 9, as you well know, is a dangerous cancer. Although there may not be any immediate evidence of metastasis there is a high likelihood that a Gleason 9 patient will see tumors that have spread outside the prostate via the blood or lymph systems even though they might be microscopic and otherwise undetectable. Your treatment course, which i personally think was very wise on your part, went after the cancer in an aggressive way. The radiation attacked the prostate cancer cells within the target area of the IMRT and the Firmagon works to curb cell growth in those areas that were not radiated.

    The fact that your PSA continues to drop is a good sign in my lay opinion. It suggests to me that your treatment is working as intended. What i suspect that the PA was trying to say is that the Firmagon (or any hormone therapy drug) should knock the PSA levels down to near zero levels regardless of whether or not any other treatment has occurred. I'm certainly no expert on hormone therapy and I don't know what the normal range of expected PSA scores should be given your Gleason 9 starting point. I would request an email exchange or arrange for a telephone chat with your lead physician and ask him what his opinion of a PSA = 0.28 after being on Firmagon for a year really means for a Gleason 9 patient and whether this is within a normal range or not.

    You really won't get a feel for the effectiveness of the radiation treatment until you have stopped hormone therapy and your testosterone leeks return to normal. This could take several months after you stop taking shots.

    Men who retain their prostates will never see a zero PSA score. (Although HT skews this data) Their PSA will decline until a nadir, or low point, is reached, and then stays at that level. If PSA results raise more than 2.0 ng/ml above the nadir it is usually considered a recurrence.

    One phenomena associated with radiation treatment is the PSA bounce effect where the PSA declines after treatment then inexplicably increases and then continues a decline toward nadir. Perhaps your reading was somewhere during the bounce phase? I would also query your doctor about his thoughts on PSA bounce.

    In any event your PSA continues to decline and that is a very good thing from my perspective. Whether or not there is a "cure" seems off point to me. What I think you should be asking is: Is this cancer going to progress to a terminal late stage that kills you? I think its way, way to early to draw that conclusion on that and the PA should have made that clear to you. I wish your PA had taken the time to put all of these numbers and nuances in perspective for you and I hope you seek further clarification with the doctor in person.

    Best to you.

    K

    THANK YOU FOR THE REPLY
    KONGO & FRIENDS

    THANK YOU FOR THE REPLY

    YOU TOOK MORE TIME answering my question than the PA spent with me

    I have to see the doctor sometime--hopefully


    Radiation Hopeful
  • tarhoosier
    tarhoosier Member Posts: 195 Member

    THANK YOU FOR THE REPLY
    KONGO & FRIENDS

    THANK YOU FOR THE REPLY

    YOU TOOK MORE TIME answering my question than the PA spent with me

    I have to see the doctor sometime--hopefully


    Radiation Hopeful

    Stable is good
    Regarding psa: Stable is good. Declining is also good.
    Notwithstanding other issues, stable is good.
  • VascodaGama
    VascodaGama Member Posts: 3,555 Member

    Stable is good
    Regarding psa: Stable is good. Declining is also good.
    Notwithstanding other issues, stable is good.

    Another perspective at your last results
    Radhope

    Firstly let me congratulate the fact of another decrease in PSA. It seems that the downward trend continues; now probably approaching a plateau. This time the decrease is 7% from the previous test. Your “zero” is not there yet but your PA is totally erroneous if he equals success to a zero number (0.00000000) in a patient with similar stats.

    Kongo passed you the correct opinion with regards to cure and recurrence. PSA is not a marker to judge cure but treatment success. This success is seen in regards to cancer control, recovery to normal living standards and health. One never returns to the same conditions it was before the treatment.

    You may know by now that levels of PSA are influenced by many factors (infections included) not just by the treatment protocol. The responses to the medication also influence outcomes. Your doctor may have a threshold which he uses as reference to define your case. I would recommend you to inquire with him in your next visit.

    As far as we laymen can judge your case, you have not recurred. One must wait for the nadir and check for any progress through periodical testing (one every 3 to 4-months) to draw a conclusion. The side effects of Firmagon may be affecting the way you judge what is told to you. Relax and do not become anxious. Try to enjoy life. How about another trip to the God's Country (Potter County) at northern Pennsylvania, or a visit to my Portugal?


    Here is a link you may find interesting in reading;

    “According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for Prostate Cancer (4), additional treatment may be indicated based on the following PSA test results:
    o For men who have been in the watchful waiting phase—their PSA level has doubled in fewer than 3 years or they have a PSA velocity (change in PSA level over time) of greater than 0.75 ng/mL per year, or they have a prostate biopsy showing evidence of worsening cancer (4).
    o For men who have had a radical prostatectomy (removal of the prostate gland)—their PSA level does not fall below the limits of detection after surgery or they have a detectable PSA level (> 0.3 ng/mL) that increases on two or more subsequent measurements after having no detectable PSA (4).
    o For men who have had other initial therapy, such as radiation therapy with or without hormonal therapy—their PSA level has risen by 2 ng/mL or more after having no detectable PSA or a very low PSA level (4)".

    http://www.cancer.gov/cancertopics/factsheet/detection/PSA

    Hope for the best.

    VGama
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    Another perspective at your last results
    Radhope

    Firstly let me congratulate the fact of another decrease in PSA. It seems that the downward trend continues; now probably approaching a plateau. This time the decrease is 7% from the previous test. Your “zero” is not there yet but your PA is totally erroneous if he equals success to a zero number (0.00000000) in a patient with similar stats.

    Kongo passed you the correct opinion with regards to cure and recurrence. PSA is not a marker to judge cure but treatment success. This success is seen in regards to cancer control, recovery to normal living standards and health. One never returns to the same conditions it was before the treatment.

    You may know by now that levels of PSA are influenced by many factors (infections included) not just by the treatment protocol. The responses to the medication also influence outcomes. Your doctor may have a threshold which he uses as reference to define your case. I would recommend you to inquire with him in your next visit.

    As far as we laymen can judge your case, you have not recurred. One must wait for the nadir and check for any progress through periodical testing (one every 3 to 4-months) to draw a conclusion. The side effects of Firmagon may be affecting the way you judge what is told to you. Relax and do not become anxious. Try to enjoy life. How about another trip to the God's Country (Potter County) at northern Pennsylvania, or a visit to my Portugal?


    Here is a link you may find interesting in reading;

    “According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for Prostate Cancer (4), additional treatment may be indicated based on the following PSA test results:
    o For men who have been in the watchful waiting phase—their PSA level has doubled in fewer than 3 years or they have a PSA velocity (change in PSA level over time) of greater than 0.75 ng/mL per year, or they have a prostate biopsy showing evidence of worsening cancer (4).
    o For men who have had a radical prostatectomy (removal of the prostate gland)—their PSA level does not fall below the limits of detection after surgery or they have a detectable PSA level (> 0.3 ng/mL) that increases on two or more subsequent measurements after having no detectable PSA (4).
    o For men who have had other initial therapy, such as radiation therapy with or without hormonal therapy—their PSA level has risen by 2 ng/mL or more after having no detectable PSA or a very low PSA level (4)".

    http://www.cancer.gov/cancertopics/factsheet/detection/PSA

    Hope for the best.

    VGama

    Latest PSA result
    Hello VGAMA & KONGO

    Just found out my latest pSA result is now 0.31---it was 0.35 in JULY-- will see doctor on Monday the 27th for appointment. Don't know if he will give me another shot of Firmagon or what. Although this is lower than the lst test ,it's still not as low as the 0.28 I had in June of this year.
    Appreciate any input regarding the latest result.

    Cordially
    Rad Hopeful
  • VascodaGama
    VascodaGama Member Posts: 3,555 Member

    Latest PSA result
    Hello VGAMA & KONGO

    Just found out my latest pSA result is now 0.31---it was 0.35 in JULY-- will see doctor on Monday the 27th for appointment. Don't know if he will give me another shot of Firmagon or what. Although this is lower than the lst test ,it's still not as low as the 0.28 I had in June of this year.
    Appreciate any input regarding the latest result.

    Cordially
    Rad Hopeful

    Hypogonadism may be affecting your reasoning
    RadHope

    Your post is “intriguing”. I wonder if hypogonadism is “taking a toll” in your reasoning.
    It is difficult to help you with a reasonable answer for the lack of information.
    I would like to know about the follow up of your last post where you commented of getting a testosterone test to check for Firmagon effectiveness. What are the results?
    What is your doctor-in-charge comment with regards to the level of PSA?
    The PA (urologist) is passing you his views on your case, but does he have any threshold PSA that he follows or uses as a reference in similar cases as that of yours?

    Here is the link of your last post;
    http://csn.cancer.org/node/243447#comment-1256916

    A decrease is good but you should consider any progress with larger intervals of tests.

    Relax.
    VG
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    Hypogonadism may be affecting your reasoning
    RadHope

    Your post is “intriguing”. I wonder if hypogonadism is “taking a toll” in your reasoning.
    It is difficult to help you with a reasonable answer for the lack of information.
    I would like to know about the follow up of your last post where you commented of getting a testosterone test to check for Firmagon effectiveness. What are the results?
    What is your doctor-in-charge comment with regards to the level of PSA?
    The PA (urologist) is passing you his views on your case, but does he have any threshold PSA that he follows or uses as a reference in similar cases as that of yours?

    Here is the link of your last post;
    http://csn.cancer.org/node/243447#comment-1256916

    A decrease is good but you should consider any progress with larger intervals of tests.

    Relax.
    VG

    TESTERONE RESULTS
    thank you VG for the reply

    I will post the testerone results as soon as I get them in the mail. I will also post what the doctor tells me on Monday

    Rad Hopeful
  • Kongo
    Kongo Member Posts: 1,166 Member

    Latest PSA result
    Hello VGAMA & KONGO

    Just found out my latest pSA result is now 0.31---it was 0.35 in JULY-- will see doctor on Monday the 27th for appointment. Don't know if he will give me another shot of Firmagon or what. Although this is lower than the lst test ,it's still not as low as the 0.28 I had in June of this year.
    Appreciate any input regarding the latest result.

    Cordially
    Rad Hopeful

    Trend
    Rad Hopeful,

    Given that individual PSA readings are subject to a lot of variation (time of day, lab equipment calibration, overall body chemistry, statistical distribution, etc.) I think an individual measurement at the second decimal level is much less important than the prevailing trend. In your case that's a downward trend. That's a good thing.

    Hope all continues in the same direction.

    Best
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218
    Kongo said:

    Trend
    Rad Hopeful,

    Given that individual PSA readings are subject to a lot of variation (time of day, lab equipment calibration, overall body chemistry, statistical distribution, etc.) I think an individual measurement at the second decimal level is much less important than the prevailing trend. In your case that's a downward trend. That's a good thing.

    Hope all continues in the same direction.

    Best

    CONFirmed results in mail
    V GAMA & LONGO
    THaNKS For thr replies I truly appreciate them.
    Got latest blood results in mail today>> Testosterone is less than 20----range on paper shows 120 to 767 ng/dl and my PSA shows 0.31 with a range of less than 4.00 ng/ml
    I wiil post what the doctor (urologist) tells me on Monday the 27th.
    This is the first testosterone check I had & that is because I asked to have it taken----is this "OK" to be so low? No wonder I"m tired & I thought it was the Firmagon

    Rad Hopeful
  • VascodaGama
    VascodaGama Member Posts: 3,555 Member

    CONFirmed results in mail
    V GAMA & LONGO
    THaNKS For thr replies I truly appreciate them.
    Got latest blood results in mail today>> Testosterone is less than 20----range on paper shows 120 to 767 ng/dl and my PSA shows 0.31 with a range of less than 4.00 ng/ml
    I wiil post what the doctor (urologist) tells me on Monday the 27th.
    This is the first testosterone check I had & that is because I asked to have it taken----is this "OK" to be so low? No wonder I"m tired & I thought it was the Firmagon

    Rad Hopeful

    Castration
    RadHope

    Testosterone at 20 ng/dl is within the range of castration (lower than 30). This indicates that Firmagon is effective in keeping your “balls” quiet. They are not producing testosterone so that you are in chemo castration.
    This is a status of hypogonadism (low testosterone levels) that may cause risks and symptoms which you can identify through other tests and own feelings. You should care for bone loss (osteoporosis) heart health (arrest) and liver function (lipids).

    I do not recall your age and urologists do not demand bone density scans for young people, but the continuous castration status causes osteopenia leading to osteoporosis. You should get a DEXA test now ($50) even if your uro does not send you for one.
    Here is the link to a previous post about the matter:
    http://csn.cancer.org/node/210934#comment-1087051

    Regarding tiredness, this is probably the number one symptom reported by all survivors. In my case it was the one that most affected me. I am now on “vacations” from the treatment and feel my strengths back. I feel much better but the levels of testosterone circulating in my body are still lower but increasing.
    I wonder what have been your experience regarding symptoms from the treatment.

    Enjoy.
    VGama
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    Castration
    RadHope

    Testosterone at 20 ng/dl is within the range of castration (lower than 30). This indicates that Firmagon is effective in keeping your “balls” quiet. They are not producing testosterone so that you are in chemo castration.
    This is a status of hypogonadism (low testosterone levels) that may cause risks and symptoms which you can identify through other tests and own feelings. You should care for bone loss (osteoporosis) heart health (arrest) and liver function (lipids).

    I do not recall your age and urologists do not demand bone density scans for young people, but the continuous castration status causes osteopenia leading to osteoporosis. You should get a DEXA test now ($50) even if your uro does not send you for one.
    Here is the link to a previous post about the matter:
    http://csn.cancer.org/node/210934#comment-1087051

    Regarding tiredness, this is probably the number one symptom reported by all survivors. In my case it was the one that most affected me. I am now on “vacations” from the treatment and feel my strengths back. I feel much better but the levels of testosterone circulating in my body are still lower but increasing.
    I wonder what have been your experience regarding symptoms from the treatment.

    Enjoy.
    VGama

    SYMPTOMS FROM TREATMENT
    VGama

    THANK You for the reply ---I appreciate the info

    The symptoms I got from Firmagon shots are some tiredness, injection site pain in the stomach & an occassional hot flash, other than that I felt good.
    I ALSO Had a blood test & everything is in the normal range except the testosterone & RBC automated which was 4.11 the range is 4.6 to 6.20
    I will see the doctor (urologist) this morning then post what I'm told-- Saw the actual doctor -- he told me the PSA will have fluctuations at this low level,that it's nothing to be concerned about. ONLY if the PSA keeps rising will it be a concern. He ordered a DEXASCAN for tomorrow ---if the results aren't favorable, he said he will put me on PROLIA. I Got another shot of FIRMAGON in the stomach but no prescription for a PSA test, the PA told me it wasn't necessary to have a test every month. The nurse giving the shot had difficulty emptying the Firmagon needle ---she said she hopes it's "OK". The fluid wouldn't come out of the needle until she pulled the long needle out of the stomach a little. It sure is causing a bulge in the stomach, don't know what she could have been against? Hope the bone density scan comes back with good results, I don't want PROLIA---been taking calcium every day for months & was told I shouldn't take any calcium pills prior to the test. I questioned the low testosterne level & was told nothing will be given to me to raise it, that woul be like pouring gas on a fire.
    The doctor performed a DRE & said everything seemed good ---the prostrate was smooth & he only felt small ridges from the radiation---NO LUMPS. HAVE A GREAT DAY

    RAD HOPEFUL Rad Hopeful
  • Samsungtech1
    Samsungtech1 Member Posts: 351

    SYMPTOMS FROM TREATMENT
    VGama

    THANK You for the reply ---I appreciate the info

    The symptoms I got from Firmagon shots are some tiredness, injection site pain in the stomach & an occassional hot flash, other than that I felt good.
    I ALSO Had a blood test & everything is in the normal range except the testosterone & RBC automated which was 4.11 the range is 4.6 to 6.20
    I will see the doctor (urologist) this morning then post what I'm told-- Saw the actual doctor -- he told me the PSA will have fluctuations at this low level,that it's nothing to be concerned about. ONLY if the PSA keeps rising will it be a concern. He ordered a DEXASCAN for tomorrow ---if the results aren't favorable, he said he will put me on PROLIA. I Got another shot of FIRMAGON in the stomach but no prescription for a PSA test, the PA told me it wasn't necessary to have a test every month. The nurse giving the shot had difficulty emptying the Firmagon needle ---she said she hopes it's "OK". The fluid wouldn't come out of the needle until she pulled the long needle out of the stomach a little. It sure is causing a bulge in the stomach, don't know what she could have been against? Hope the bone density scan comes back with good results, I don't want PROLIA---been taking calcium every day for months & was told I shouldn't take any calcium pills prior to the test. I questioned the low testosterne level & was told nothing will be given to me to raise it, that woul be like pouring gas on a fire.
    The doctor performed a DRE & said everything seemed good ---the prostrate was smooth & he only felt small ridges from the radiation---NO LUMPS. HAVE A GREAT DAY

    RAD HOPEFUL Rad Hopeful

    Stomach shots
    I quit because of the nurse. Ended up with swelling that they thought, after 10 days, was either abcessed, or infected. Stayed that way for six weeks. Quit shots. Doctor came over and gave me a shot. It was ok. Now nurse is using that as a guide. Tough enough for the shot, but when nurse does not give a darn, you are on your own, complain, or quit like I did. Worked for me.

    Mike
  • VascodaGama
    VascodaGama Member Posts: 3,555 Member

    Stomach shots
    I quit because of the nurse. Ended up with swelling that they thought, after 10 days, was either abcessed, or infected. Stayed that way for six weeks. Quit shots. Doctor came over and gave me a shot. It was ok. Now nurse is using that as a guide. Tough enough for the shot, but when nurse does not give a darn, you are on your own, complain, or quit like I did. Worked for me.

    Mike

    What a relief !!!
    RadHope

    Those are wonderful news. You may be thrilled and very happy for the doctor’s comments.
    I am also happy to know about the DRE results and that you finally will start having PSA tests at longer intervals.

    I hope the DEXA scan is negative for osteoporosis but if it is found that you got osteopenia you may start a preventive approach taking on/off bisphosphonate pills (such as Fosamax). If you got advanced osteoporosis (bone loss) then you should consider taking a bisphosphonate continuously or take a denosumab drug (human monoclonal antibody). Prolia and Xgeva are famous denosumab drugs for treating bone loss due to cancer or in patients at high risk for bone fracture.
    You may dislike the Prolia recommended by your doctor for what you know about its side effects but not all patients experience the same occurrences or intensity. You may inquire with your doctor about the possibility of changing it with Xgeva.
    In any case, both drugs require a series of “standards” before taking them which you must follow strictly. Both “deliver” similar side effects, being hypocalcemia (low levels of calcium in the blood) the one most reported.

    Regarding low count of RBC, you may check if your body got enough vitamin B12. This is required for the “production” of RBC. Inquire with your doctor particularly to check for Anemia.
    I also recommend you to get tested for vitamin D. This is important in the osteoblast effect (build up of bone). http://www.medterms.com/script/main/art.asp?articlekey=24502

    You do not need to worry about low levels of Testosterone for the moment. You can expect it to increase once you stop the Firmagon.

    Have a good time.
    VGama
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    What a relief !!!
    RadHope

    Those are wonderful news. You may be thrilled and very happy for the doctor’s comments.
    I am also happy to know about the DRE results and that you finally will start having PSA tests at longer intervals.

    I hope the DEXA scan is negative for osteoporosis but if it is found that you got osteopenia you may start a preventive approach taking on/off bisphosphonate pills (such as Fosamax). If you got advanced osteoporosis (bone loss) then you should consider taking a bisphosphonate continuously or take a denosumab drug (human monoclonal antibody). Prolia and Xgeva are famous denosumab drugs for treating bone loss due to cancer or in patients at high risk for bone fracture.
    You may dislike the Prolia recommended by your doctor for what you know about its side effects but not all patients experience the same occurrences or intensity. You may inquire with your doctor about the possibility of changing it with Xgeva.
    In any case, both drugs require a series of “standards” before taking them which you must follow strictly. Both “deliver” similar side effects, being hypocalcemia (low levels of calcium in the blood) the one most reported.

    Regarding low count of RBC, you may check if your body got enough vitamin B12. This is required for the “production” of RBC. Inquire with your doctor particularly to check for Anemia.
    I also recommend you to get tested for vitamin D. This is important in the osteoblast effect (build up of bone). http://www.medterms.com/script/main/art.asp?articlekey=24502

    You do not need to worry about low levels of Testosterone for the moment. You can expect it to increase once you stop the Firmagon.

    Have a good time.
    VGama

    DEXASCAN RESULTS
    Hello VG & KONGO

    I"M somewhat upset right now but I wanted to share the results of my dexca scan with you (just got copy in the mail)---
    Image of lumber spine is unremarkable--it is in the osteopenic range with a T-score of -2.4 (FRACTURE RISK IS MODERATE)

    LEFT HIP T_score of -2.9 FRACTURE RISK IS HIGH
    RIGHT HIP T-score of -2.9 FRACTURE RISK IS HIGH
    DISTal LEFT FOREarm T score of -4.0 FRACTURE RISK IS HIGH

    IMPRESSION: 1. Osteoporosis 2. FRACTURE RISK IS HIGH
    RECommendation > THerapy is recommended

    LOOKS LIKE I'M going to be put on PROLIA as the doctor stated------in the mean time I must be careful not to break any bones

    THIS ISN't the result I wished for bUT what can you do

    Rad Hopeful
  • VascodaGama
    VascodaGama Member Posts: 3,555 Member

    DEXASCAN RESULTS
    Hello VG & KONGO

    I"M somewhat upset right now but I wanted to share the results of my dexca scan with you (just got copy in the mail)---
    Image of lumber spine is unremarkable--it is in the osteopenic range with a T-score of -2.4 (FRACTURE RISK IS MODERATE)

    LEFT HIP T_score of -2.9 FRACTURE RISK IS HIGH
    RIGHT HIP T-score of -2.9 FRACTURE RISK IS HIGH
    DISTal LEFT FOREarm T score of -4.0 FRACTURE RISK IS HIGH

    IMPRESSION: 1. Osteoporosis 2. FRACTURE RISK IS HIGH
    RECommendation > THerapy is recommended

    LOOKS LIKE I'M going to be put on PROLIA as the doctor stated------in the mean time I must be careful not to break any bones

    THIS ISN't the result I wished for bUT what can you do

    Rad Hopeful

    Be Strong
    RadHope

    I am sorry for the diagnosis of osteoporosis. I wonder if you have done a density scan before so that you can compare the results. In any case the T -2.9 is conclusive of weaker bone and the hormonal therapy may affect still more any progression of the loss.

    You need to take something. You can inquire with your doctor if he would recommend you just a bisphosphonate instead of Prolia. However, not to alarm you but you should get a dental check up and dental repairs done the soonest because bisphosphonates and denosumab drugs (Prolia, Xgeva, etc) in time can cause osteonecrosis of the jaw.
    You can read about it here;
    http://dentistry.about.com/od/toothmouthconditions/a/Osteonecrosis.htm
    http://www.algaecal.com/Blog/denosumab-aka-prolia-xgeva-even-worse-than-the-bisphosphonates/11454

    As you commented “……in the mean time I must be careful not to break any bones”.

    Be strong
    VG
  • Samsungtech1
    Samsungtech1 Member Posts: 351

    DEXASCAN RESULTS
    Hello VG & KONGO

    I"M somewhat upset right now but I wanted to share the results of my dexca scan with you (just got copy in the mail)---
    Image of lumber spine is unremarkable--it is in the osteopenic range with a T-score of -2.4 (FRACTURE RISK IS MODERATE)

    LEFT HIP T_score of -2.9 FRACTURE RISK IS HIGH
    RIGHT HIP T-score of -2.9 FRACTURE RISK IS HIGH
    DISTal LEFT FOREarm T score of -4.0 FRACTURE RISK IS HIGH

    IMPRESSION: 1. Osteoporosis 2. FRACTURE RISK IS HIGH
    RECommendation > THerapy is recommended

    LOOKS LIKE I'M going to be put on PROLIA as the doctor stated------in the mean time I must be careful not to break any bones

    THIS ISN't the result I wished for bUT what can you do

    Rad Hopeful

    Test results
    Just wondering; what kind of meal plans are you on? Are you exercising?

    Was it just radiation, or are you on HT as well?

    Mike
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    Test results
    Just wondering; what kind of meal plans are you on? Are you exercising?

    Was it just radiation, or are you on HT as well?

    Mike

    ANSWER TO YOUR QUESTIONS
    Dear Samsungtech1

    1/ I had the radiation treatments & I'm taking the hormone drug Firmagon for almost two years
    2/ I DO NOT eat any red meat --only chicken, turkey. pasta & fish.
    3/ I walk alot & exercise by cutting wood & placing it on skids

    Hope this helped you in understanding my disposition

    Rad Hopeful
  • Samsungtech1
    Samsungtech1 Member Posts: 351

    ANSWER TO YOUR QUESTIONS
    Dear Samsungtech1

    1/ I had the radiation treatments & I'm taking the hormone drug Firmagon for almost two years
    2/ I DO NOT eat any red meat --only chicken, turkey. pasta & fish.
    3/ I walk alot & exercise by cutting wood & placing it on skids

    Hope this helped you in understanding my disposition

    Rad Hopeful

    Disposition
    Hopeful,
    Just checking. Would hate for someone to fightthis and hurt themselves without a nutrition plan.
    Did not mean to upset you.

    Good luck with your journey.

    Mike
  • RADIATION HOPEFUL
    RADIATION HOPEFUL Member Posts: 218

    Disposition
    Hopeful,
    Just checking. Would hate for someone to fightthis and hurt themselves without a nutrition plan.
    Did not mean to upset you.

    Good luck with your journey.

    Mike

    Nutrition Plan & frameof mind
    Dear SAMsungtech1

    I Didn't mean to sound disrespectable, my latest Dexa Scan results have me in a down mood.
    I'm very concerned about thr results as I posted above.

    Rad Hopeful