What do you think?
I am a 75 year old who was diagnosed with prostate cancer one year ago. I had Gleason 9 and no metastasis to the bone but to the lymph nodes. I've been on hormone therapy since Jan 2022 (eligard). My PSA went from 16 to 0.37 in March. In June it was at 0.72. I had radiation in August - September (26 sessions) on the prostate and lymphs. I just had the most recent blood test and the PSA was 0.35. The testosterone is and has been at under 0.4. I am due to start Xtandi (enzalutamide) soon. I would appreciate your comments.
Comments
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Hi,
With the radiation you probably still have live Prostate tissue generating PSA. Unless the whole Prostate was radiated you will continue to generate a certain amount of PSA. The Xtandi should kick it down the road even further(lower). Both the Eligard and Xtandi are testosterone lowering drugs and thus weaken the cancer cells. It my humble opinion if your PSA stays flatline more or less, that would be the desired result. More nuclear scans in the future should tell you if your cancer is in fact remission and has not continued to spread. Good luck over the coming months.
Dave 3+4
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Hi
If the testosterone test units are ng/dL (0.4 ng/dL), then I believe that your doctor's rational in adding the xtandi (antiandrogen drug) is due to the previous increase of the PSA in spite of being on eligard. Surely a testosterone test should have been done at that timing too to confirm if castration levels (PSA< 20.0 ng/dL) have been reached.
Typically Xtandi is added to eligard in Castration-Resistant Prostate Cancer cases, which could have been your doctor's judgment.
Let's wait for the PSA results at 6-months after the RT treatment. Increase would represent a bad prognosis. In any case, the PSA is masked by the ADT effects.
You will know about the treatment success only after the end of the effects of the drugs. What is your ADT schedule?
Best
VG
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Hi VG,
I thank you for sharing your understanding. You are correct that the Xtandi is a result of my PSA increase in June. This was followed up with radiation late summer and the Xtandi is to start soon. I will be taking the Xtandi in a daily form and the Eligard (30MG) is injected every four months, next injection in January. The six month post radiation will be the end of March. For an impatient person that's a long time to wait, but there will be ongoing tests and I hope a scan or two.
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