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Thread: What I Need to Know About HT

  1. #21
    Quote Originally Posted by Robnj View Post
    Hi guys,
    Been on HT for what will be 3 years in May 12' Lupron, Casodex added in Dec. 13'. My last PSA was 0.19 in Oct. 14'. What is a reasonable expectation of your PSA numbers when you still have a prostate? Correct me if i'm wrong but I don't see how it can be undetectable.
    Thanks..........
    Rob
    Personally, the only expectation is that the PSA numbers/curve will "flatten out" at some point and hopefully remain there for some duration (6mo's to +8yrs). Two or more consecutive tests with the same (or difference between readings within a reasonable margin of measurement error) I'd consider a "flat spot".

    My PSA hopefully is still dropping so I've not had the discussion with the DR as to what he'll consider my "low point" or "nadair" when it happens.

    I can say that I was warned before hand that each case is different and as such each man's "low point" is a different value. From what I've come to understand, the lower the value of the "flat spot" the better the prognosis.

    I wish I could comment on how long it might take to reach the "flat spot" as a diagnostic indicator however I've read several seemingly conflicting studies on this and currently prefer not to worry/stress about it.
    - George

    55yo at diagnosis 3/14, PSA=395, 1 week later PSA=322, 98cc prostate at biopsy: 16/16 positive, 15-G9 (4+5), 1-G6(unknown). Stage4: T3BN1M0, "Metastatic to pelvic Lymph node" (bone scan clear) 12/14 DEX=normal, 12/16 DEX=normal

    - Currently on ADT/TAB: Lupron 4mo+Cassodex
    - PSA 03/14=322
    - PSA 06/14=55.88
    - PSA 08/14=37.63
    - PSA 10/14=11.35
    - PSA 12/14=6.78
    - PSA 04/15=2.69
    - PSA 04/16=0.38
    - PSA 04/17=0.19
    - PSA 08/17=0.16 Start Lupron Vacation #1
    - PSA 09/17=0.14
    - PSA 04/18=0.17, T=100
    - 5/18 Restart Lupron
    - 6/18 Start 40 sessions RT (8 weeks)
    - 8/18 End RT.
    - 9/18 Get last scheduled Lupron shot
    - PSA 09/18=0.12 (First post radiation reading)
    - PSA 01/19=0.09
    - PSA 07/19=0.06

  2. #22
    Regular User
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    Jan 2015
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    Thanks George,
    Very informative, so informative i'm gonna print it and let my Uro read it when I see him in Feb. He can get into the details with me.
    Thanks again.........
    All the best..........
    Rob

  3. #23
    Regular User
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    Jan 2015
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    22
    Guys,
    Here are my numbers from last year>
    1-10-14 0.97
    2- 7-14 0.285
    6- 3-14 0.084
    8- 6-14 0.10
    9-29-14 0.19
    Would appreciate any opinions on these numbers. They are from 2 different Labs as I was going back and forth between my Uro & regular MD. After last Sept. I decided to not be so obsessive with it, but last year obviously I was.
    Thanks guys.......
    Rob

  4. #24
    Regular User
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    Jan 2015
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    I'm figuring my next test in Feb. will say a lot on where this is going.

  5. #25
    Quote Originally Posted by Robnj View Post
    Guys,
    Here are my numbers from last year>
    1-10-14 0.97
    2- 7-14 0.285
    6- 3-14 0.084
    8- 6-14 0.10
    9-29-14 0.19
    Would appreciate any opinions on these numbers. They are from 2 different Labs as I was going back and forth between my Uro & regular MD. After last Sept. I decided to not be so obsessive with it, but last year obviously I was.
    Thanks guys.......
    Rob
    If they are from 2 different labs, they may have been done by 2 different standards, the WHO and Hybritech. WHO standard PSA tests yield a lower result.

    http://www.mayomedicallaboratories.c...sa/10b-19.html

  6. #26
    Regular User
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    Jan 2015
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    22
    Southsider,
    Thanks for that info...never knew that! I was aware that you should really go with one lab, even having the blood drawn at the same time. But, I never knew there were 2 standards of testing.
    Rob

  7. #27
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,298
    Yes, it is VERY important to make sure that PSA tests, to be compared to each other, all be from the same lab to ensure that the same assey is performed. I can make somewhat of a difference when two different labs do it.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  8. #28
    Regular User
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    Jan 2015
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    22
    Hi Guys,
    Just got my most recent blood test, it went from 0.19 (9/29/14) to 0.97 on 2/11/15. Obviously that is a big jump, I did expect it to rise......but was hoping not that much! This gets back to my question of never being undetectable while still having a prostate. GeorgeS had mentioned a "flatspot", obviously this isn't it. But what number area would be considered acceptable in my situation. 2? 3?, if it should flatten out in that area. I have not seen my URO yet as I get the blood test the week before. He mostly talks about a "pattern", which I guess is similar to flatspot. I hope I am satisfied with his answers.....I may be approaching the time of getting another opinion/hosptal involved.
    As always, any input would be appreciated.......
    Rob

  9. #29
    Logically there are 3 "patterns" that a DR can consider: dropping, staying (mostly) the same and rising. In the rising they look at the "PSA doubling time" - IE: how long it takes for the PSA value to double.

    It sounds like you may have an interesting conversation with your Doctor on the next visit!

    I go in ~1st week of April for my 4mo test and after results are back shortly afterwards get another shot.
    - George

    55yo at diagnosis 3/14, PSA=395, 1 week later PSA=322, 98cc prostate at biopsy: 16/16 positive, 15-G9 (4+5), 1-G6(unknown). Stage4: T3BN1M0, "Metastatic to pelvic Lymph node" (bone scan clear) 12/14 DEX=normal, 12/16 DEX=normal

    - Currently on ADT/TAB: Lupron 4mo+Cassodex
    - PSA 03/14=322
    - PSA 06/14=55.88
    - PSA 08/14=37.63
    - PSA 10/14=11.35
    - PSA 12/14=6.78
    - PSA 04/15=2.69
    - PSA 04/16=0.38
    - PSA 04/17=0.19
    - PSA 08/17=0.16 Start Lupron Vacation #1
    - PSA 09/17=0.14
    - PSA 04/18=0.17, T=100
    - 5/18 Restart Lupron
    - 6/18 Start 40 sessions RT (8 weeks)
    - 8/18 End RT.
    - 9/18 Get last scheduled Lupron shot
    - PSA 09/18=0.12 (First post radiation reading)
    - PSA 01/19=0.09
    - PSA 07/19=0.06

  10. #30
    Senior User
    Join Date
    Dec 2014
    Posts
    232
    I'm also from Jersey, far south, getting treated at DVU in Cherry Hill. Wondering what part of the state you hail from and where you are getting help? I'm very good with the folks I'm working with.
    Consider adding a signature page for others to compare with. Best of luck with your treatment and progress.
    Age 70, ( now 73 ) consistent low psa till now, dre's are very important as this got way ahead of me without them!
    PSA rise 3.8 to 4.3 ( 10/2014 )
    No family history, one of eleven siblings.
    Biopsy 11/20/14 Gleason 9 with 5+4, T2c score
    9 or 10 of 12 positive 12/04/14
    Cat scan, bone scan, m r i show confined to prostate gland
    Two weeks intensive research....HT and radiation decision made
    First HT 12/16/14 lots of side effects ( Degarelix ) (3/11 pain and bruising at injection site, sleep issues, sweats and maybe some dark thoughts)
    Second HT 1/13 no side effects ( Eligard )( much easier than the 30 day, no pain or bruising, only sweats and sleep issues )
    Cat scan and tattoos 3/6/15 Dry run 3/18 actual radiation on 3/19
    Wrapped up the radiation on 5/22 and met the Memorial Day goal!
    Second six month Eligard on 7/14/15. If follow up PSA test goes well may opt out.
    .01 PSA at 90 day follow up, opted out of h t after a year. Still undetectable after three years.

 

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