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Thread: Lupron and on and on?

  1. #11
    Personally, I finished the radiation in August of last year. Both the RO and I feel that any residual PSA is from PC that won't die.

    We recently discussed my getting or not another shot of Lupron. While it was very arguable ether way in the end we opted for another shot. Keep kicking it while its down I say.
    - 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

  2. #12
    Rooster has provided a good description of how ADT works. As stated, it is not believed to actually kill cancer cells, but starves them of fuel and the ability to reproduce. Cancer cells are natural bodily cells that thru genetic mutation have lost the mechanism of cell death known as apoptosis that causes normal cells to die off naturally and be replaced by young healthy cells.

    Ordinary fleas can live on water and dead cells sloughed off of their host, but they need to consume blood in order to reproduce. Flea collars work by poisoning the fleas as they crawl up to the head to get water from the corner of the host's eye. They then die either before or after they have laid eggs, so to eradicate the colony it is necessary to maintain the toxic barrier long enough for the offspring to go thru the same "death trap".

    Prostate cancer cells, as I understand it, divide on an eight month cycle. The idea behind long term ADT is to prevent the cancer cells from producing new cells. It doesn't kill them, but prevents them from reproducing. The "new" cells that were "born" around the time of treatment may live long enough to avoid the deadly radiation and will divide after eight months, but without the testosterone, they will not be able divide again another eight months later. Hence the entire cycle lasts about sixteen months.

    Okay, I probably got a few technical details wrong, but that's the general idea. Those guys who had localized prostate cancer can get away with six months of ADT surrounding their course of radiation. Personally I was initially told that I would likely be on ADT for a full three years, but the new thinking of 18 months came around right around the time I was undergoing adjuvant RT, and because my PSA remained low my ADT ended eight months after completing radiation. But it does stick with you for quite a while afterwards.

    I fear that perhaps the OP may be thinking with his little head between his legs rather than the big head on top of his shoulders. Believing that you can avoid the majority of side effects and just go with a short course of SBRT and enjoy a few years of life filled with sex while still able... sort of "going out with a bang", may sound appealing, but when the end approaches one will likely look back and wish he'd done more early on to fight the disease. And besides, after a few months on ADT, one doesn't care about sex anymore. In fact, I don't even remember what was so great about it. There are many things that I miss now, but being constantly obsessed with sex for most of my adult life isn't one of them.
    Late 2012: PSA 4, age 62 all DRE's 'normal' ... Early 2014: PSA 9.5, TRUS biopsy negative
    2015: PSA's 12 & 20, LOTS of Cipro ... Mar'16: PSA 25, changed Urologist
    Jun'16: MRI fusion biopsy, tumor right base, 6/16 cores: 2-40%+2-100% G8(4+4)
    Aug'16: DaVinci RP, -SM, 11 LN-, 53g, 25% involved, PNI, 6mm EPE, BL SVI, pT3B
    Jan'17: started 18 months Lupron ADT, uPSA's ~.03
    May'17: AMS800 implanted, revised 6/17
    Aug'17: 39 tx (70 Gy) RapidArc IGIMRT
    Jan'18-Jan 2019: PSA's <0.008, T=9 (still on Lupron)
    Apr'18: Dx radiation colitis, Oct'18: Tx sclerosing mesenteritis
    "Everyone you meet is fighting a battle you cannot see"
    Mrs: Dec 2016
    Dx stage 4 NHL/DLBCL, Primary Bone Lymphoma
    spinal RT boost+6X R-CHOP21+IT MTX via LP. Now in remission
    Read our story at CancerCoupleBlog

  3. #13
    Very good post Rob, well written and very informative. Thank u. MM
    DOB:Feb 1958
    PSA: 9/15: 5.9
    DRE: Negative
    Biopsy: 10/1/15. Second Opinion University of Chicago. +9 of 12 cores. G6: 5 cores, G7 ( 4+3) 4 cores
    10/12/15: -CT scan/BS
    Clinical Staging: 10/28/15 T2c
    ( RALP) UC 12/29/15

    Final Pathology Report; Jan. 6 2016

    -15 lymph nodes
    G9 ( 4+5)
    +EPE
    +LVI
    +Right SV -Left SV and vasa deferentia,
    PI present
    PM
    pT3bNO
    uPSA 2/9/16 0.05
    uPSA 3/23/16 0.11
    Casodex 4/1/16-8/5/16
    Lupron 4/15/16-5/15/18
    SRT 6/14/16...8/5/16 38Tx
    uPSA 8/10/16---2/14/19 <0.05
    Feb. 2017 Loyola Chicago
    11/15/2018 AUS 800 Implanted
    12/18/18...T Levels...Free T 42.8...Total T...262

 

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