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philip popolous
Posts: 3
Joined: Jan 2013

Dear All,

I need support if possible! I am 55 years old

I was diagnosed with agressive Gleason 9 prostate Cancer in October 2011 with a PSA of 53.
My doctor put me right away on Eligard shots every six month and 35 Radiotion sessions ended in February 2012

The surgery was not an option bearing in mind that the cancer has escaped the Prostate gland and CT scan showed Lymph nodes envolvment but I was lucky that the Bone scan came out negative.

MY PSA Dropped to 2.4 in April 2012
In July PSA droppoed to 1.54
Last week my PSA came back to read 3.1

My doctor suggested that I start taking Casodox 50MG daily along with the Eligard shots, but he said that if the Casodox did not knock down the PSA that will mean that my Cancer has became Refractory.

I would appreciate any advice from member to what should I expect in the future as I am so confused now and in a deep frostration.

I look forward to your feedback

London, Ontario

VascodaGama's picture
Posts: 3406
Joined: Nov 2010


I am sorry for your PCa condition with increasing PSA.

You have not shared details of the treatment protocol and I take it as you had only one Eligard shot before RT.

In such a case, an increase in PSA would be expected to occur because the effectiveness of the drug has ended. In fact, to verify for the effectiveness of the radiation portion, one should have PSA tests without the HT influence. If such case applies to you then you got a must lower level of PSA (from 53 to 3.1).

The problem of refractory is if you have been on continuous Eligard shots leading you to castrate levels of testosterone, and in such status your PSA has increased. To verify such you need to get a Testosterone test and check for castrate levels.

In other words, refractory is only declared if the HT portion of the treatment becomes eneffective.

Typically, when refractory is experienced, doctors increase the protocol by adding drugs and their potency. Many suggest tripple blockade with a combination of agonists (Eligard) plus an antiandrogen (Casodex) plus an 5-ARI (Avodart). Once these drugs become eneffective then the patient is moved to a second line HT with drugs that act at intratumoral levels, such as Zytiga and  Xtandy.

I recommend you reading the book from Dr. Myers that explains well about hormonal treatments and refractory;

“Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers

Apart of Testosterone and PSA tests you should verify for any bone loss (DEXA scan) and the lipids to avoid amenia, etc. Heart problems may also be a cause from the treatments for PCA. Have it tested too.

You should also care for diet and physical fitness to sustain the side effects from progressive cancer case.

Best wishes for improvements.

VGama  Wink

Posts: 1
Joined: Nov 2013

My cancer is also valued as 9  which I guess means very aggresive.  But my PSA was 15.  I am currently on lupron for 2 to 3 years and 39 treatments of proton radiation.  I guess you could descibe me the healthiest looking 70 year old that is very sick.  You take care young man. 

Posts: 58
Joined: May 2013

Tedolz, do you have bone mets?

Stay healthy!!! MLN

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