Psa 74

"Livingman",
Welcome back to the forum. I am sorry if things along the last two years have not been in your favor. I wonder if you ever got a trustful clinical stage before engaging in radiation therapies. What was the PSA before starting ADT and proton? Surely if that was in the 100th then the present 74 is good. Was the PSA=67 (indicated above) the value in 2017, at the time of the holistic treatment?
We may help you with opinions but we need to know the details since your last post. What do you want to know specifically from survivors here?

Your shared info regarding the treatment protocol of Casodex plus Proton is rare. The hormonal that lead to better outcomes in radiation therapies are the agonists. Why did they use solo antiandrogens?

The image exams done so far have been all false negatives. You may have micrometastases that are hard to be detected by traditional CT scans. I recommend you to get a PET 68Ga-PSMA exam to try locating the hidden bandit. You can then draw a plan of attack with confidence.
You need the next PSA result to confirm RT failure. At that time the doctor may declare you Systemic, which by norm are cases treated with chemo therapies. Nothing wrong with this and you should be positive to the idea of continuing treatment.

Here is your story; https://csn.cancer.org/node/307160

Let us know more about symptoms or any other aspect regarding the RT side effects.

Best of lucks

VG

Chuckect said:

would love to hear more about holistic treatment

i'm on zytiga, prednesone, xgeva, lupron, hydrocodone, zoloft, and think about adding radium 223.. So I would love to know if the holistic approch has any benifit.  I sometimes feel like i am tired of taking all of these meds.. How long were you on the holistic regime ? I have stage 4 metistatic prostate cancer and my scans look like a black skeleton, so i am very interested in anything different.. later gater and good luck

Chuckect,

As a recently diagnosed high-risk patient myself, I am days away from a final decision on my first-line of treatment (i.e., RP/ADT or RT), and I have just today begun initial but long overdue treatment with Casodex. However, if I have ANY regrets at all, its the misguided faith that I put into advanced imaging techniques and their potential to clarify things with respect to metastasis.

Having been told from day-1 by multiple practicioners that CT scans, bone scans, PET scans and MRIs woiuld likely prove to be very helpful in elucidating the localized or non-localized nature of my disease, and further, that ADT drugs could potentially interfere with the uptake of various tracers used in those imaging events, I mistakenly placed more value on the scans themselves than the ADT treatments, and that was a MAJOR error on my part. Like you, an array of 5-6 different imaging modalities (CT. bone, Pet, MRI, etc.), proved to be pointless exercises, and because of scheduling issues, these various scans lead to several months of unnecessary delays in beginning treatment. So, if I had any meaningful advice for newly diagnosed patients of PCa, it would be this . . . skip the CT, bone and most forms of PET scan, and get a high-quality 3T-MRI instead, then proceed with your treatment of choice. Had I done this, its safe to say that my treatment would have begun over 100-days ago, which was valuable time lost.

VascodaGama said:

Totally disagree

Regulator,

This post seems from someone that is desperate. I disagree with your comments. I do not think that it was a mistake for you to place more value on image exams firstly before starting a hormonal treatment. Cancer patients need to gather evidence on their status before deciding on a therapy. That is what your doctors did and they did it very well in accordance with the recommended guidelines in urology/oncology. Moreover, hormonal therapies of the type of antiandrogens you comment would work the same if they have been started today or 100 days ago. They do not kill the cancer but simply turn the cancerous cells sort of indolent. There was no valuable time lost in the way you have proceded. Be positive. You will knowk down the bandit to the canvas.

VG,

As always, I greatly appreciate your wisdom, comments and viewpoint, even when its critical of me or my own views, and you're right, I am frustrated - not "desperate" necessarily, but certainly frustrated.

I don't wish to hijack the OP's thread by opening up another unrelated conversation here, but I think a brief explanation is in order:

When I was first diagnosed, it became immediately clear that there were only going to be two principal treatment approaches available to me . . . 1) surgery followed by RT-ADT/HT or 2) RT followed by ADT/HT. It also became clear rather quickly, that even if I wanted surgery, it might not ever be available to me, based upon a variety of case-specific factors, one of which was whether the cancer was "localized" or not.

Needless to say, given my preference for surgery over RT, this prompted me to seek out (and yes, almost "insist" upon) advanced imaging techniques, in hopes that it would help better elucidate the situation (re: localization), even when some of the medical specialists didn't necessarily support such imaging. In my case, the vast majority of those "advanced" imaging tests (5 out of 6), proved to be anything BUT "advanced", and as a result, valuable time would appear to have been wasted. That was my point to the OP and other readers here, and I stand by that point.

That said, you appear to believe that 100-days is an inconsequential period of time in such instances, and I fully respect your opinion on that, but I can assure you (based upon some of their comments to me), that several of the medical professionals I have seen over that period of time, would respectfully yet promptly disagree with you on that point.

Thank you again for your many valuable contributions here.

Deadmansoon said:

First psa at dx was 39, had 3

First psa at dx was 39, had 3 doctors offer me nothing but hormone therapy, I refused and went with holistic. On holistic program 2 weeks in my psa dropped to 31, slowly got it to 28, after 6 months I started losing the battle and was rising every month, when it got to 67 I went to procure in OKC. They did scans and put me on 6 weeks of casodex to get swelling down before proton, after 25 treatments they waited 30 days then permanent brachytherapy.  I don't know how high psa got I'm assuming about a 100. After the 6 weeks of casodex psa was 26. 3 month check-up after brachytherapy psa is 74. I'm pretty sure it should've been alot lower but still have alot of swelling from both treatments. Seem to be feeling better and urinating better and no new symptoms, hoping 6 month follow up shows improvment. 

Deadmansoon,

My circumstances are somewhat similar to yours, with a high PSA (67), rapid PSA doubling time, high Gleason, etc., and I can certainly appreciate why you would be concerned about a stationary PSA value following such major treatment events. I too am now on Casodex, and in all liklihood, I'll be seeing Lupron injections and IMRT or SBRT treatments before the summer is out, so I will be watching your progress closely and wishing you the very best in the weeks ahead. Like you however, I've gotta believe that its a temporary anomaly of sorts, related solely to the timing of things. Specifically, I've gotta believe that the sheer physical 'molestation' of the gland by the radiation events (and the swelling produced by those events), is causing an agitated state and sustained production of PSA as a result. We'll all be crossing our fingers for you.

All the best! 

Deadmansoon said:

Been researching for a week

Been researching for a week now, and haven't found any cases of such a high psa first follow up brachytherapy. I'm convinced treatment has failed. Guess all I got left is hormone therapy, very depressing at age 41. Good luck to everyone out there, and thanks for all the advice. God bless.

We can hope for the better, but it does look like further treatment may be necessary. Has any doctor talked to you about chemo (usually taxotere)? It's typically used once the cancer has metastasized. In this context, have you had any recent scans to see if the cancer has metastasized?