Re: My husband's PSA rise

[Guest guest]

" shedorman@... " wrote:

> I've tried to keep up with the posts of the group..Maybe I'm

> just looking for someone to tell me it's noting to worry about.

> My husband had 44 IMRT treatments and was on Zoladex for one

> year. I believe it's been almost a year and a half. But we got

> a true reading in April when most of the hormones were out of

> his system. Six months ago it was 0.20 three months later it's

> now 0.26. A year ago it was 0.01, but he still had hormones in

> his system. He's been complaining about a lot of back pain

> also. He mentioned going to the doctor. Should we have another

> bone scan??,,,it's been at least 2 years since we had the last

> one. I'm waiting to hear from the specialist. He always sends

> me notes on what he thinks. I just wanted to hear what Steve

> Jordan thought too. I hope you read this Steve. I'll try to be

> patient and wait to hear from the doctor I just put in a call.

> But I just want other ideas too. Best wishes to all and hope

> you are all hanging in there.

Sheila,

So far, the numbers look good to me. As you say, the 0.01

reading was bogus. That number was caused by the ADT. It's

possible that, even in April, there was some influence of the ADT

on PSA. Even after the ADT wears off, it takes months for,

first, the testosterone to recover and then, second, for the PSA

to recover to it's normal level.

The actual number 0.26 looks excellent to me. I had radiation

plus ADT. After the ADT wore off, my PSA fluctuated wildly. It

started (after the ADT was worn off) at 0.8, went to 0.6, up to

1.8, down to 0.9, up to 1.2 and so on. It took three years to

drop below 0.5. Today, 6.5 years after treatment, my last

reading was 0.09.

When I was 15 months past treatment, my PSA was 1.8! Your

husband is doing a lot better than I did and, as you can see, I'm

doing very well.

We're never completely out of the woods with this disease. It's

always possible to get a recurrence even many years after

treatment. However it appears that your husband is progressing

as well as, or even better than, one can expect from a successful

treatment.

So don't be alarmed at the tiny rise in the numbers. I don't

think there's any reason yet to believe that the treatment isn't

working.

Alan

[Guest guest]

Hello Alan,

I thought your reply to Shiela was very good. As you may remember if you've read my posts I'm just short of 24 months (Nov 4) after 40 msessions IGRT. Like you my PSA has been all over the place; even up to 9.9 at one point (PSA 5.56 at diagnosis. Back in May my Onco told me to prepare for the worst (ie ADT) at my next quarter as my level was then 3.5 (tho it had been 4.92 four days earlier). However with my PSA down to 2.62 ng/ml in September my Onco is happy to refrain from further TX, namely ADT. Alan can i ask if you have had any other periods of ADT in addition to the original? Were you on ADT when your PSA was 1.8? Did you take any supplements at that time?

I'm really pleased for you that your PSA has dropped to a very good level for radation TX and hope it continues to stay low.

Best regards,

Malaga,Spain

Re: My husband's PSA rise

"shedorman@..." wrote:> I've tried to keep up with the posts of the group..Maybe I'm> just looking for someone to tell me it's noting to worry about.> My husband had 44 IMRT treatments and was on Zoladex for one> year. I believe it's been almost a year and a half. But we got> a true reading in April when most of the hormones were out of> his system. Six months ago it was 0.20 three months later it's> now 0.26. A year ago it was 0.01, but he still had hormones in> his system. He's been complaining about a lot of back pain> also. He mentioned going to the doctor. Should we have another> bone scan??,,,it's been at least 2 years since we had the last> one. I'm waiting to hear from the specialist. He always sends> me notes on what he thinks. I just wanted to hear what Steve> Jordan thought too. I hope you read this Steve. I'll try to be> patient and wait to hear from the doctor I just put in a call.> But I just want other ideas too. Best wishes to all and hope> you are all hanging in there.Sheila,So far, the numbers look good to me. As you say, the 0.01reading was bogus. That number was caused by the ADT. It'spossible that, even in April, there was some influence of the ADTon PSA. Even after the ADT wears off, it takes months for,first, the testosterone to recover and then, second, for the PSAto recover to it's normal level.The actual number 0.26 looks excellent to me. I had radiationplus ADT. After the ADT wore off, my PSA fluctuated wildly. Itstarted (after the ADT was worn off) at 0.8, went to 0.6, up to1.8, down to 0.9, up to 1.2 and so on. It took three years todrop below 0.5. Today, 6.5 years after treatment, my lastreading was 0.09.When I was 15 months past treatment, my PSA was 1.8! Yourhusband is doing a lot better than I did and, as you can see, I'mdoing very well. We're never completely out of the woods with this disease. It'salways possible to get a recurrence even many years aftertreatment. However it appears that your husband is progressingas well as, or even better than, one can expect from a successfultreatment.So don't be alarmed at the tiny rise in the numbers. I don'tthink there's any reason yet to believe that the treatment isn'tworking.Alan

[Guest guest]

Hello Alan,

I thought your reply to Shiela was very good. As you may remember if you've read my posts I'm just short of 24 months (Nov 4) after 40 msessions IGRT. Like you my PSA has been all over the place; even up to 9.9 at one point (PSA 5.56 at diagnosis. Back in May my Onco told me to prepare for the worst (ie ADT) at my next quarter as my level was then 3.5 (tho it had been 4.92 four days earlier). However with my PSA down to 2.62 ng/ml in September my Onco is happy to refrain from further TX, namely ADT. Alan can i ask if you have had any other periods of ADT in addition to the original? Were you on ADT when your PSA was 1.8? Did you take any supplements at that time?

I'm really pleased for you that your PSA has dropped to a very good level for radation TX and hope it continues to stay low.

Best regards,

Malaga,Spain

Re: My husband's PSA rise

"shedorman@..." wrote:> I've tried to keep up with the posts of the group..Maybe I'm> just looking for someone to tell me it's noting to worry about.> My husband had 44 IMRT treatments and was on Zoladex for one> year. I believe it's been almost a year and a half. But we got> a true reading in April when most of the hormones were out of> his system. Six months ago it was 0.20 three months later it's> now 0.26. A year ago it was 0.01, but he still had hormones in> his system. He's been complaining about a lot of back pain> also. He mentioned going to the doctor. Should we have another> bone scan??,,,it's been at least 2 years since we had the last> one. I'm waiting to hear from the specialist. He always sends> me notes on what he thinks. I just wanted to hear what Steve> Jordan thought too. I hope you read this Steve. I'll try to be> patient and wait to hear from the doctor I just put in a call.> But I just want other ideas too. Best wishes to all and hope> you are all hanging in there.Sheila,So far, the numbers look good to me. As you say, the 0.01reading was bogus. That number was caused by the ADT. It'spossible that, even in April, there was some influence of the ADTon PSA. Even after the ADT wears off, it takes months for,first, the testosterone to recover and then, second, for the PSAto recover to it's normal level.The actual number 0.26 looks excellent to me. I had radiationplus ADT. After the ADT wore off, my PSA fluctuated wildly. Itstarted (after the ADT was worn off) at 0.8, went to 0.6, up to1.8, down to 0.9, up to 1.2 and so on. It took three years todrop below 0.5. Today, 6.5 years after treatment, my lastreading was 0.09.When I was 15 months past treatment, my PSA was 1.8! Yourhusband is doing a lot better than I did and, as you can see, I'mdoing very well. We're never completely out of the woods with this disease. It'salways possible to get a recurrence even many years aftertreatment. However it appears that your husband is progressingas well as, or even better than, one can expect from a successfultreatment.So don't be alarmed at the tiny rise in the numbers. I don'tthink there's any reason yet to believe that the treatment isn'tworking.Alan

[Guest guest]

Hello Alan,

I thought your reply to Shiela was very good. As you may remember if you've read my posts I'm just short of 24 months (Nov 4) after 40 msessions IGRT. Like you my PSA has been all over the place; even up to 9.9 at one point (PSA 5.56 at diagnosis. Back in May my Onco told me to prepare for the worst (ie ADT) at my next quarter as my level was then 3.5 (tho it had been 4.92 four days earlier). However with my PSA down to 2.62 ng/ml in September my Onco is happy to refrain from further TX, namely ADT. Alan can i ask if you have had any other periods of ADT in addition to the original? Were you on ADT when your PSA was 1.8? Did you take any supplements at that time?

I'm really pleased for you that your PSA has dropped to a very good level for radation TX and hope it continues to stay low.

Best regards,

Malaga,Spain

Re: My husband's PSA rise

"shedorman@..." wrote:> I've tried to keep up with the posts of the group..Maybe I'm> just looking for someone to tell me it's noting to worry about.> My husband had 44 IMRT treatments and was on Zoladex for one> year. I believe it's been almost a year and a half. But we got> a true reading in April when most of the hormones were out of> his system. Six months ago it was 0.20 three months later it's> now 0.26. A year ago it was 0.01, but he still had hormones in> his system. He's been complaining about a lot of back pain> also. He mentioned going to the doctor. Should we have another> bone scan??,,,it's been at least 2 years since we had the last> one. I'm waiting to hear from the specialist. He always sends> me notes on what he thinks. I just wanted to hear what Steve> Jordan thought too. I hope you read this Steve. I'll try to be> patient and wait to hear from the doctor I just put in a call.> But I just want other ideas too. Best wishes to all and hope> you are all hanging in there.Sheila,So far, the numbers look good to me. As you say, the 0.01reading was bogus. That number was caused by the ADT. It'spossible that, even in April, there was some influence of the ADTon PSA. Even after the ADT wears off, it takes months for,first, the testosterone to recover and then, second, for the PSAto recover to it's normal level.The actual number 0.26 looks excellent to me. I had radiationplus ADT. After the ADT wore off, my PSA fluctuated wildly. Itstarted (after the ADT was worn off) at 0.8, went to 0.6, up to1.8, down to 0.9, up to 1.2 and so on. It took three years todrop below 0.5. Today, 6.5 years after treatment, my lastreading was 0.09.When I was 15 months past treatment, my PSA was 1.8! Yourhusband is doing a lot better than I did and, as you can see, I'mdoing very well. We're never completely out of the woods with this disease. It'salways possible to get a recurrence even many years aftertreatment. However it appears that your husband is progressingas well as, or even better than, one can expect from a successfultreatment.So don't be alarmed at the tiny rise in the numbers. I don'tthink there's any reason yet to believe that the treatment isn'tworking.Alan

[Guest guest]

El Horizonte

> Hello Alan,

>

> I thought your reply to Shiela was very good. As you may

> remember if you've read my posts I'm just short of 24 months

> (Nov 4) after 40 msessions IGRT. Like you my PSA has been all

> over the place; even up to 9.9 at one point (PSA 5.56 at

> diagnosis. Back in May my Onco told me to prepare for the worst

> (ie ADT) at my next quarter as my level was then 3.5 (tho it

> had been 4.92 four days earlier). However with my PSA down to

> 2.62 ng/ml in September my Onco is happy to refrain from

> further TX, namely ADT. Alan can i ask if you have had any

> other periods of ADT in addition to the original? Were you on

> ADT when your PSA was 1.8? Did you take any supplements at that

> time?

> I'm really pleased for you that your PSA has dropped to a very

> good level for radation TX and hope it continues to stay low.

Hi

I do indeed remember your posts and have worried about you. I

was very glad to read of your PSA drop when you informed us.

I had two injections of Lupron, one was a nominal 30 day dose

about 6 weeks before radiation began and the other was a nominal

90 day dose. I say " nominal " because the actual effects lasted

more than 120 days. It was more like 150 days and maybe 180

before my testosterone levels were above low normal. The docs

wanted to give me more, but I they found that my " liver enzymes "

level was elevated, which indicates liver damage, and they

believed that the ADT was causing it. So they stopped the ADT.

After they did, the liver enzyme level returned to normal.

If I remember correctly, the 1.8 reading was about 15 months

after treatment. The ADT had completely worn off well before

then. The bounce was from 0.6 to 1.8 in 3 months. Later I had

another bounce. I don't recall the numbers but I think it may

have been from 0.9 to 1.2.

It's impossible to know what my actual maximum PSA was after

treatment. It was bouncing around enough that if I had taken a

PSA test every week I might have seen much greater variation than

I saw. after the first bounce from .6 to 1.8, the rad onc had me

tested every month for six months in hopes of getting more

detailed information about what was happening. But who knows

what the actual peak was. It might have happened between tests

and might have been substantially higher than 1.8.

I was treated in a clinical trial. IIRC the guy running the

trial told me that of the 14 men in the trial, 4 had bounces and

the highest was 2.4. However, again IIRC, he told me he knew of

cases of bounces as high as 16.

Your PSA was high for a bounce, but well short of the highest.

Your subsequent drop is an extremely good sign. I say extremely

because when a person has cancer that is growing out of control,

the PSA doesn't go down. It goes up. Most of the cases I know

about of failed radiation the PSA went down immediately after

radiation, then began a steady climb. It didn't bounce up and

down. It went down, then up, then up, then up, then up, and up

and up.

Well, time will tell.

Best of luck.

Alan

[Guest guest]

Thank you for the encouragement Alan. My next test is shortly before Xmas so I'm remaining hopeful for that. In the meantime I'm sticking with the pomegranate extract tabs, green tea tabs, turmeric, flax seeds, plenty of broccoli and of couse my home grown fresh pomegranates to help the radiation along!

Best regards,

Chris

Re: My husband's PSA rise

El Horizonte > Hello Alan,> > I thought your reply to Shiela was very good. As you may> remember if you've read my posts I'm just short of 24 months> (Nov 4) after 40 msessions IGRT. Like you my PSA has been all> over the place; even up to 9.9 at one point (PSA 5.56 at> diagnosis. Back in May my Onco told me to prepare for the worst> (ie ADT) at my next quarter as my level was then 3.5 (tho it> had been 4.92 four days earlier). However with my PSA down to> 2.62 ng/ml in September my Onco is happy to refrain from> further TX, namely ADT. Alan can i ask if you have had any> other periods of ADT in addition to the original? Were you on> ADT when your PSA was 1.8? Did you take any supplements at that> time?> I'm really pleased for you that your PSA has dropped to a very> good level for radation TX and hope it continues to stay low.Hi I do indeed remember your posts and have worried about you. Iwas very glad to read of your PSA drop when you informed us.I had two injections of Lupron, one was a nominal 30 day doseabout 6 weeks before radiation began and the other was a nominal90 day dose. I say "nominal" because the actual effects lastedmore than 120 days. It was more like 150 days and maybe 180before my testosterone levels were above low normal. The docswanted to give me more, but I they found that my "liver enzymes"level was elevated, which indicates liver damage, and theybelieved that the ADT was causing it. So they stopped the ADT.After they did, the liver enzyme level returned to normal.If I remember correctly, the 1.8 reading was about 15 monthsafter treatment. The ADT had completely worn off well beforethen. The bounce was from 0.6 to 1.8 in 3 months. Later I hadanother bounce. I don't recall the numbers but I think it mayhave been from 0.9 to 1.2.It's impossible to know what my actual maximum PSA was aftertreatment. It was bouncing around enough that if I had taken aPSA test every week I might have seen much greater variation thanI saw. after the first bounce from .6 to 1.8, the rad onc had metested every month for six months in hopes of getting moredetailed information about what was happening. But who knowswhat the actual peak was. It might have happened between testsand might have been substantially higher than 1.8.I was treated in a clinical trial. IIRC the guy running thetrial told me that of the 14 men in the trial, 4 had bounces andthe highest was 2.4. However, again IIRC, he told me he knew ofcases of bounces as high as 16.Your PSA was high for a bounce, but well short of the highest.Your subsequent drop is an extremely good sign. I say extremelybecause when a person has cancer that is growing out of control,the PSA doesn't go down. It goes up. Most of the cases I knowabout of failed radiation the PSA went down immediately afterradiation, then began a steady climb. It didn't bounce up anddown. It went down, then up, then up, then up, then up, and upand up.Well, time will tell.Best of luck.Alan

[Guest guest]

Why flax saeed-full of omega 6 which causes inflamtion. Why not fish Omega 3.

Tom W

To: ProstateCancerSupport Sent: Wed, October 20, 2010 2:58:51 PMSubject: Re: My husband's PSA rise

Thank you for the encouragement Alan. My next test is shortly before Xmas so I'm remaining hopeful for that. In the meantime I'm sticking with the pomegranate extract tabs, green tea tabs, turmeric, flax seeds, plenty of broccoli and of couse my home grown fresh pomegranates to help the radiation along!

Best regards,

Chris

Re: My husband's PSA rise

El Horizonte > Hello Alan,> > I thought your reply to Shiela was very good. As you may> remember if you've read my posts I'm just short of 24 months> (Nov 4) after 40 msessions IGRT. Like you my PSA has been all> over the place; even up to 9.9 at one point (PSA 5.56 at> diagnosis. Back in May my Onco told me to prepare for the worst> (ie ADT) at my next quarter as my level was then 3.5 (tho it> had been 4.92 four days earlier). However with my PSA down to> 2.62 ng/ml in September my Onco is happy to refrain from> further TX, namely ADT. Alan can i ask if you have had any> other periods of ADT in addition to the original? Were you on> ADT when your PSA was 1.8? Did you take any supplements at that>

time?> I'm really pleased for you that your PSA has dropped to a very> good level for radation TX and hope it continues to stay low.Hi I do indeed remember your posts and have worried about you. Iwas very glad to read of your PSA drop when you informed us.I had two injections of Lupron, one was a nominal 30 day doseabout 6 weeks before radiation began and the other was a nominal90 day dose. I say "nominal" because the actual effects lastedmore than 120 days. It was more like 150 days and maybe 180before my testosterone levels were above low normal. The docswanted to give me more, but I they found that my "liver enzymes"level was elevated, which indicates liver damage, and theybelieved that the ADT was causing it. So they stopped the ADT.After they did, the liver enzyme level returned to normal.If I remember correctly, the 1.8 reading was about 15 monthsafter

treatment. The ADT had completely worn off well beforethen. The bounce was from 0.6 to 1.8 in 3 months. Later I hadanother bounce. I don't recall the numbers but I think it mayhave been from 0.9 to 1.2.It's impossible to know what my actual maximum PSA was aftertreatment. It was bouncing around enough that if I had taken aPSA test every week I might have seen much greater variation thanI saw. after the first bounce from .6 to 1.8, the rad onc had metested every month for six months in hopes of getting moredetailed information about what was happening. But who knowswhat the actual peak was. It might have happened between testsand might have been substantially higher than 1.8.I was treated in a clinical trial. IIRC the guy running thetrial told me that of the 14 men in the trial, 4 had bounces andthe highest was 2.4. However, again IIRC, he told me he knew ofcases of bounces as high as

16.Your PSA was high for a bounce, but well short of the highest.Your subsequent drop is an extremely good sign. I say extremelybecause when a person has cancer that is growing out of control,the PSA doesn't go down. It goes up. Most of the cases I knowabout of failed radiation the PSA went down immediately afterradiation, then began a steady climb. It didn't bounce up anddown. It went down, then up, then up, then up, then up, and upand up.Well, time will tell.Best of luck.Alan

[Guest guest]



Hi Tom,

Flax seeds have the highest natural levels of lignans of all food stuffs. Lignans are supposed to have an anti cancer effect. My Oncologist actually prescribed 2 tbsp a day during my IGRT. Besides natural flax seeds are incredibly cheap here in Spain, which capsules/supplements aren't. I don't personally believe that any foods stuff or supplement is likely to cure PCa but I'm happy to give my PCa cells as much hassle as possible to let the radiation TX do it's work!

Spain

Re: My husband's PSA rise

El Horizonte > Hello Alan,> > I thought your reply to Shiela was very good. As you may> remember if you've read my posts I'm just short of 24 months> (Nov 4) after 40 msessions IGRT. Like you my PSA has been all> over the place; even up to 9.9 at one point (PSA 5.56 at> diagnosis. Back in May my Onco told me to prepare for the worst> (ie ADT) at my next quarter as my level was then 3.5 (tho it> had been 4.92 four days earlier). However with my PSA down to> 2.62 ng/ml in September my Onco is happy to refrain from> further TX, namely ADT. Alan can i ask if you have had any> other periods of ADT in addition to the original? Were you on> ADT when your PSA was 1.8? Did you take any supplements at that> time?> I'm really pleased for you that your PSA has dropped to a very> good level for radation TX and hope it continues to stay low.Hi I do indeed remember your posts and have worried about you. Iwas very glad to read of your PSA drop when you informed us.I had two injections of Lupron, one was a nominal 30 day doseabout 6 weeks before radiation began and the other was a nominal90 day dose. I say "nominal" because the actual effects lastedmore than 120 days. It was more like 150 days and maybe 180before my testosterone levels were above low normal. The docswanted to give me more, but I they found that my "liver enzymes"level was elevated, which indicates liver damage, and theybelieved that the ADT was causing it. So they stopped the ADT.After they did, the liver enzyme level returned to normal.If I remember correctly, the 1.8 reading was about 15 monthsafter treatment. The ADT had completely worn off well beforethen. The bounce was from 0.6 to 1.8 in 3 months. Later I hadanother bounce. I don't recall the numbers but I think it mayhave been from 0.9 to 1.2.It's impossible to know what my actual maximum PSA was aftertreatment. It was bouncing around enough that if I had taken aPSA test every week I might have seen much greater variation thanI saw. after the first bounce from .6 to 1.8, the rad onc had metested every month for six months in hopes of getting moredetailed information about what was happening. But who knowswhat the actual peak was. It might have happened between testsand might have been substantially higher than 1.8.I was treated in a clinical trial. IIRC the guy running thetrial told me that of the 14 men in the trial, 4 had bounces andthe highest was 2.4. However, again IIRC, he told me he knew ofcases of bounces as high as 16.Your PSA was high for a bounce, but well short of the highest.Your subsequent drop is an extremely good sign. I say extremelybecause when a person has cancer that is growing out of control,the PSA doesn't go down. It goes up. Most of the cases I knowabout of failed radiation the PSA went down immediately afterradiation, then began a steady climb. It didn't bounce up anddown. It went down, then up, then up, then up, then up, and upand up.Well, time will tell.Best of luck.Alan

[Guest guest]

Please forgive my tardiness with this response.

> I've tried to keep up with the posts of the group..Maybe I'm just

> looking for someone to tell me it's noting to worry about. My

> husband had 44 IMRT treatments and was on Zoladex for one year.

Why only a year? What counts is the result. What were his PSA

results during that year?

If they were not undetectable (=/< 0.05 ng/mL) I do not believe

that it was prudent to stop the Zoladex (and any other essential

meds such as Casodex (bicalutmide) and Avodart (dutasteride).

> I believe it's been almost a year and a half. But we got a true

> reading in April when most of the hormones were out of his

> system.

This seems to reflect the notion among some that PSA results

while on an agonist such as Trelstar, Lupron in its various

guises, and Zoladex, somehow do not report the " true " level of

PSA. That is incorrect.

While on a med such as the above-named LHRH agonists, the PSA

results are what they are. If a patient stops the med, his PSA is

likely to rise. And then it is what it is. The idea of " masking "

the true PSA has no basis.

> Six months ago it was 0.20 three months later it's now

> 0.26. A year ago it was 0.01, but he still had hormones in his

> system.

That was an accurate reading.

> He's been complaining about a lot of back pain also. He

> mentioned going to the doctor. Should we have another bone

> scan??,,,it's been at least 2 years since we had the last one.

> I'm waiting to hear from the specialist. He always sends me notes

> on what he thinks.

It is conceivable that Husband has developed bone metastases. It

is well past time to check it out.

Please remind me. Is the doctor a urologist?

Best,

Steve J

" When dealing with malignant conditions you do not save your

weaponry until you are surrounded by the enemy. "

-- B. Strum, MD

Medical Oncologist

PCa Specialist

[Guest guest]

Please forgive my tardiness with this response.

> I've tried to keep up with the posts of the group..Maybe I'm just

> looking for someone to tell me it's noting to worry about. My

> husband had 44 IMRT treatments and was on Zoladex for one year.

Why only a year? What counts is the result. What were his PSA

results during that year?

If they were not undetectable (=/< 0.05 ng/mL) I do not believe

that it was prudent to stop the Zoladex (and any other essential

meds such as Casodex (bicalutmide) and Avodart (dutasteride).

> I believe it's been almost a year and a half. But we got a true

> reading in April when most of the hormones were out of his

> system.

This seems to reflect the notion among some that PSA results

while on an agonist such as Trelstar, Lupron in its various

guises, and Zoladex, somehow do not report the " true " level of

PSA. That is incorrect.

While on a med such as the above-named LHRH agonists, the PSA

results are what they are. If a patient stops the med, his PSA is

likely to rise. And then it is what it is. The idea of " masking "

the true PSA has no basis.

> Six months ago it was 0.20 three months later it's now

> 0.26. A year ago it was 0.01, but he still had hormones in his

> system.

That was an accurate reading.

> He's been complaining about a lot of back pain also. He

> mentioned going to the doctor. Should we have another bone

> scan??,,,it's been at least 2 years since we had the last one.

> I'm waiting to hear from the specialist. He always sends me notes

> on what he thinks.

It is conceivable that Husband has developed bone metastases. It

is well past time to check it out.

Please remind me. Is the doctor a urologist?

Best,

Steve J

" When dealing with malignant conditions you do not save your

weaponry until you are surrounded by the enemy. "

-- B. Strum, MD

Medical Oncologist

PCa Specialist

[Guest guest]

Steve Jordan wrote:

> > I've tried to keep up with the posts of the group..Maybe I'm just

> > looking for someone to tell me it's noting to worry about. My

> > husband had 44 IMRT treatments and was on Zoladex for one year.

>

> Why only a year? What counts is the result. What were his PSA

> results during that year?

There's a lot of debate about this issue. I have seen studies

that say that best results are obtained if a person continues

adjuvant ADT for two or more years, and others that say that six

months confers all the benefit that the patient is going to get -

more is gratuitous.

....

> > I believe it's been almost a year and a half. But we got a true

> > reading in April when most of the hormones were out of his

> > system.

>

> This seems to reflect the notion among some that PSA results

> while on an agonist such as Trelstar, Lupron in its various

> guises, and Zoladex, somehow do not report the " true " level of

> PSA. That is incorrect.

>

> While on a med such as the above-named LHRH agonists, the PSA

> results are what they are. If a patient stops the med, his PSA is

> likely to rise. And then it is what it is. The idea of " masking "

> the true PSA has no basis.

You're absolutely right Steve, but I think Sheila wanted to know

whether the radiation was doing it's job of killing off the

cancer. ADT makes it impossible to know the answer to that

question. However, now that her husband has stopped ADT, they'll

be able to find out more about the effectiveness of the

radiation.

The new reading of 0.26 strikes me as very good. Even without

the influence of ADT, the PSA is well below what I think most

radiation oncologists would consider a satisfactory number for

this stage of treatment.

> It is conceivable that Husband has developed bone metastases. It

> is well past time to check it out.

I think it's possible that there are bone metastases, but I can't

recall a single case of a patient on this or other groups that I

follow of a man having painful bone metastases with a PSA of only

0.26. More commonly, the PSA is in the hundreds or even

thousands before pain develops.

I also think that checking it out will be difficult. One problem

is that the scanning techniques that we have find denser than

expected areas of the bone, but don't say whether the denser

areas are caused by cancer or something else like arthritis.

Unless there is a fair amount of cancer, which is very unlikely

with a PSA of only 0.26, I think a bone scan is likely to either

show nothing, or show a false positive, rather than a true

positive.

A lot of older people have backaches. I do. My wife does. A

lot of people I know do. I think the first thing I would look

for are the usual culprits - strains, sprains, muscle pulls,

osteoarthritis, disk problems, etc.

If it were me I would try slow and careful stretching every

morning to limber things up, and judicious use of ibuprofen. A

heating pad might help too. For myself, I've found that taking

two ibuprofen before going to bed can keep things under control

during the night so I wake up reasonably limber and pain free.

Alan

[Guest guest]

Steve Jordan

wrote:

> > I've tried to keep up with the posts of the group..Maybe I'm just

> > looking for someone to tell me it's noting to worry about. My

> > husband had 44 IMRT treatments and was on Zoladex for one year.

>

> Why only a year? What counts is the result. What were his PSA

> results during that year?

There's a lot of debate about this issue. I have seen studies

that say that best results are obtained if a person continues

adjuvant ADT for two or more years, and others that say that six

months confers all the benefit that the patient is going to get -

more is gratuitous.

I just had this talk with my Oncologist. I am now 7 weeks out from my 35

sessions of IMRT. We discussed how long I should remain on ADT. He

said that the studies are all over the place on how you should stay on ADT

after radiation. He has seen as short as 6 months and as long as 2 years and some

even recommended continuing indefinitely. His current thinking is 1 year

is a good amount of time and anything longer and he has seen only get marginal

improvements. I have been on ADT for a year now, partially as neo

adjuvant therapy before surgery, continuing on while recovering from surgery

and then through radiation. I am not too crazy about staying on for

another year either. My next shot isn’t until November so we have

until then to make some choices.

[Guest guest]

Quoting me:

> Why only a year? What counts is the result. What were his PSA

> results during that year?

Alan wrote:

" There's a lot of debate about this issue. I have seen studies

that say that best results are obtained if a person continues

adjuvant ADT for two or more years, and others that say that six

months confers all the benefit that the patient is going to get -

more is gratuitous. "

I'll have to rant on, then. The TIME on ADT is not the primary

measure; the PSA *result* while on ADT is the absolutely vital

datum. The recommendation of knowledgeable med oncs such as

Strum, Lee, Scholz, etc. is that the measure of success is one

year on ADT WITH undetectable PSA tests. The measure being =/<

0.05 ng/mL.

IMO, anything less is self-delusion.

> A lot of older people have backaches. I do. My wife does. A

> lot of people I know do. I think the first thing I would look

> for are the usual culprits - strains, sprains, muscle pulls,

> osteoarthritis, disk problems, etc.

Well, I guess I'm an " older people. "

Point is, I recently performed what the medical perfession calls

a " faw go boom. " Lots of bruises & abrasions. Huge bruise on R

hip, but no fx; I reckon the Zometa is working. I'm not gonna do

THAT again!

Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.

He starts ADT and after one year his PSA is 2.9.

Hello? Hello? Is he HR (hormone refractory?) If not, W T H is

going on?

[Guest guest]

Quoting me:

> Why only a year? What counts is the result. What were his PSA

> results during that year?

Alan wrote:

" There's a lot of debate about this issue. I have seen studies

that say that best results are obtained if a person continues

adjuvant ADT for two or more years, and others that say that six

months confers all the benefit that the patient is going to get -

more is gratuitous. "

I'll have to rant on, then. The TIME on ADT is not the primary

measure; the PSA *result* while on ADT is the absolutely vital

datum. The recommendation of knowledgeable med oncs such as

Strum, Lee, Scholz, etc. is that the measure of success is one

year on ADT WITH undetectable PSA tests. The measure being =/<

0.05 ng/mL.

IMO, anything less is self-delusion.

> A lot of older people have backaches. I do. My wife does. A

> lot of people I know do. I think the first thing I would look

> for are the usual culprits - strains, sprains, muscle pulls,

> osteoarthritis, disk problems, etc.

Well, I guess I'm an " older people. "

Point is, I recently performed what the medical perfession calls

a " faw go boom. " Lots of bruises & abrasions. Huge bruise on R

hip, but no fx; I reckon the Zometa is working. I'm not gonna do

THAT again!

Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.

He starts ADT and after one year his PSA is 2.9.

Hello? Hello? Is he HR (hormone refractory?) If not, W T H is

going on?

[Guest guest]

Steve Jordan wrote:

> ...

> Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.

> He starts ADT and after one year his PSA is 2.9.

>

> Hello? Hello? Is he HR (hormone refractory?) If not, W T H is

> going on?

> ...

I think we may be talking at cross purposes Steve.

I was assuming that the original patient we were discussing was

not hormone refractory and not on ADT treatment for recurrent

cancer. Rather he was receiving adjuvant hormone therapy for a

primary radiation treatment. The intent of the ADT was not to

suppress the cancer long term, but to weaken it in order to

maximize the effect of the radiation. The hope is that the

cancer will be completely destroyed by the radiation and further

hormone therapy would never be necessary again.

Perhaps you were thinking that the person had already failed

primary treatment and was receiving ADT as a long term treatment.

If my assumption was correct, the patient would definitely be

taken off ADT after some period of time. The only question was

how long should that period of time be. I've seen studies

arguing for different periods ranging from 6 months to 2 years.

It's possible that my assumption is wrong, but if it's right, I

think the patient won't find out whether the radiation worked

until he gets off ADT and sees what happens. What happened in

this patient's case is that the PSA rose to 0.26 from its

undetectable status on ADT. 0.26 is an excellent number for

15-18 months post radiation and does not indicate a recurrence of

the cancer.

Alan

[Guest guest]

Steve Jordan wrote:

> ...

> Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.

> He starts ADT and after one year his PSA is 2.9.

>

> Hello? Hello? Is he HR (hormone refractory?) If not, W T H is

> going on?

> ...

I think we may be talking at cross purposes Steve.

I was assuming that the original patient we were discussing was

not hormone refractory and not on ADT treatment for recurrent

cancer. Rather he was receiving adjuvant hormone therapy for a

primary radiation treatment. The intent of the ADT was not to

suppress the cancer long term, but to weaken it in order to

maximize the effect of the radiation. The hope is that the

cancer will be completely destroyed by the radiation and further

hormone therapy would never be necessary again.

Perhaps you were thinking that the person had already failed

primary treatment and was receiving ADT as a long term treatment.

If my assumption was correct, the patient would definitely be

taken off ADT after some period of time. The only question was

how long should that period of time be. I've seen studies

arguing for different periods ranging from 6 months to 2 years.

It's possible that my assumption is wrong, but if it's right, I

think the patient won't find out whether the radiation worked

until he gets off ADT and sees what happens. What happened in

this patient's case is that the PSA rose to 0.26 from its

undetectable status on ADT. 0.26 is an excellent number for

15-18 months post radiation and does not indicate a recurrence of

the cancer.

Alan

[Guest guest]

Thank You Alan!!

Re: My husband's PSA rise

Steve Jordan wrote:> ...> Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.> He starts ADT and after one year his PSA is 2.9.>> Hello? Hello? Is he HR (hormone refractory?) If not, W T H is> going on?> ...I think we may be talking at cross purposes Steve.I was assuming that the original patient we were discussing wasnot hormone refractory and not on ADT treatment for recurrentcancer. Rather he was receiving adjuvant hormone therapy for aprimary radiation treatment. The intent of the ADT was not tosuppress the cancer long term, but to weaken it in order tomaximize the effect of the radiation. The hope is that thecancer will be completely destroyed by the radiation and furtherhormone therapy would never be necessary again.Perhaps you were thinking that the person had already failedprimary treatment and was receiving ADT as a long term treatment.If my assumption was correct, the patient would definitely betaken off ADT after some period of time. The only question washow long should that period of time be. I've seen studiesarguing for different periods ranging from 6 months to 2 years.It's possible that my assumption is wrong, but if it's right, Ithink the patient won't find out whether the radiation workeduntil he gets off ADT and sees what happens. What happened inthis patient's case is that the PSA rose to 0.26 from itsundetectable status on ADT. 0.26 is an excellent number for15-18 months post radiation and does not indicate a recurrence ofthe cancer.Alan

[Guest guest]

>

> > ...

> > Let's consider a hypothetical case: Patient's PSA is 3.0 ng/mL.

> > He starts ADT and after one year his PSA is 2.9.

> >

> > Hello? Hello? Is he HR (hormone refractory?) If not, W T H is

> > going on?

> > ...

>

> I think we may be talking at cross purposes Steve.

>

> I was assuming that the original patient we were discussing was

> not hormone refractory and not on ADT treatment for recurrent

> cancer. Rather he was receiving adjuvant hormone therapy for a

> primary radiation treatment. The intent of the ADT was not to

> suppress the cancer long term, but to weaken it in order to

> maximize the effect of the radiation. The hope is that the

> cancer will be completely destroyed by the radiation and further

> hormone therapy would never be necessary again.

>

> Perhaps you were thinking that the person had already failed

> primary treatment and was receiving ADT as a long term treatment.

>

> If my assumption was correct, the patient would definitely be

> taken off ADT after some period of time. The only question was

> how long should that period of time be. I've seen studies

> arguing for different periods ranging from 6 months to 2 years.

>

> It's possible that my assumption is wrong, but if it's right, I

> think the patient won't find out whether the radiation worked

> until he gets off ADT and sees what happens. What happened in

> this patient's case is that the PSA rose to 0.26 from its

> undetectable status on ADT. 0.26 is an excellent number for

> 15-18 months post radiation and does not indicate a recurrence of

> the cancer.

>

> Alan

>

Steve J. and Alan M,

I underwent a year of ADT prior to and 6 mos following Brachytheraphy.

My PSA has remained in the 0.2 to 0.3 range for the past 5+ years and was 0.3 a

mo. ago, however a CT scan last week revealed possible trouble spots in the lung

area. I'm going to a Medical Oncologist tomorrow (Wed. 10-27) for his opinion

because the radiologist's report indicated possible mets from the PCa, or

possibly is from 50 yrs. of smoking, drinking or just NJ air. I've been away

from the alt. group for a while, but still recognize that are rational

conversations there. I should have saved the old computer, it worked!

Tom