PSA from 5000 to 0.3

When my husband was diagnosed, Sept 2011, with stage 4 prostate cancer his PSA was over 5000.

He Urologist started him on Casodex which gave my husband relief for the constant bone pain within two days. Shortly thereafter Eligard injections began. Jan 2013 he had an Orchiectomy to do away with the painful injections.

Today his PSA is 8.7 (it had dropped to 0.3) and doing the watchful waiting, without any medications. Currently he is symptom free but the Oncologist believes its a matter of time before the cancer returns.

He's 72.

Any comments?

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oncologist may be right, it will return. why? perhaps after Orchiectomy psa down to 0.3, after that it come back to 8.7. few details are note given.what was your patscan report? if any psa test was done inbetween jan13 &today . what was its score. psa test is required usually after gap of every 3 months for one year -after date of proceedure -in your case in jan13. it is just to calculate
psa dubbling time,....this is most important- to decide next course of treatment.
so be vigilant of your disease-next line of action -take decision-after consulting others oncologist,urologist
wishing earlist fitness ,recovery...............

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Since my husbands psa began to rise the Urologist ( he checked him every month) sent him to the Oncologist ad we see him every 6 weeks and his gleason score was 8, 4+4.
All the research I've done since he was first diagnosed says it usually returns within 3 years, with stage 4.
At that time the cancer had metastasize to the bones with lesions in the lung and liver.

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Actually his psa had dropped down to 0.3 a few months before the orchiectomy, and it began going back up. He opted to have the Orchiectomy in place of the Eligard because of the pain of the injections. His Urologist told us from the start his psa would begin to rise again at some point.

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My husband rec'd his dx in spring 2007. All 12 biopsies were cancerous. His Gleason score was also 8. After much study and meeting with the oncologist etc we decided to go with the Eligard shots every 6 mo and to begin EBR a month later. He had 48 EBR treatments, 5 days a week until complete.
His biopsies were redone about 5.5 years after the dx and there was no cancer. The Eligard shots were hell for both of us but hte results were good. Not sure what you can do now. Have they suggested the shots now or is it too late?
Our thoughts and prayers are with you for wellness and the best course of action for you at this time. Thinking of you and yours.
EL

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he was on Eligard 14 months and chose to go with the Orchiectomy in Jan of this year because the shots were too painful.

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Wow, 5000 PSA! Down to less than one. What is Eligard and EBR?

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ELIGARD is a hormonal therapy for the management of advanced prostate cancer.
http://www.eligard.com/about-eligard/dosing.aspx
The injections are extremely painful.
When he was first diagnosed, the cancer had metastasize and he was in sever pain and had been for a couple of months, he had gotten to the point of being suicidal due to the pain.
He lost a lot of weigh and slept as much as possible.
With two day's after starting on Cosadex he was standing and walking much better, and his appetite picked up.

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Thank you. I was on Lupron which was also a Hormonal treatment with no side effects. Ten years it kept my cancer in check. Casodex had too many side effects so I quit that treatment. I wish you and your husband the very best in what is a highly personal fight with cancer. I hate to be called a survivor, I am a fighter. Survivors are those who got home free after initial treatment. Mine has been almost a twenty year battle, in treatment all the time. Good luck and God bless! Jimmy

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Starlite:
I'm confused. Hubby's psa went ALL the way down but is now moving up. My understanding is that that means there is cancer NOW somewhere, even while scans are not detecting it. Even with orchiectomy, I think hubby needs additional treatment NOW.

What is hubby's psa doubling rate now?
Has hubby had testosterone and dihydrotestosterone tested since surgery? They should be <20 and undetectable, respectively.
Discuss with oncologist the continued use of casodex AND Avodart.
Orchiectomy removes the testes as a source of testosterone, but it doesn't eliminate adrenal gland..and maybe other sources; Avodart may help there.

I think, but have no basis, that continuing eligard or Lupron, might still be beneficial. It seems that these drugs can cause metastases, in lymph nodes, lungs and even bones, to regress.

Remember, I'm not an MD.

Herb

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Starlite:
I'm back. Why eligard? Why not Lupron or Degaralix? Also, while six month shot may be more convenient, 3 mo Lupron may be somewhat more "effective" than the Lupron 4 or 6 month shots. I can't compare to eligard.
Herb

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The Eligard was every 3 months. When he was diagnosed in 2011 with advanced metastatic prostate cancer, his Urologist put him on Casodex (150 mg daily).
I was reading this...
Given that Avodart and Proscar lower PSA by about 50%, the question becomes: "Are they masking the capacity of PSA to detect cancer progression?" The answer is no. PSA still rises in men with progressive disease. In fact, studies show that Avodart and Proscar improve the accuracy of the PSA monitoring process, enhancing the likelihood of detecting High-Risk cancer.
http://www.prostateoncology.com/education/glossary/a:hormonal_therapy

I also read the following.
Avodart may also cause decreases in serum PSA in the presence of prostate cancer.

It can be confusing. He would never agree to any injections. He refused Provenge because of this. His Oncologist said he was eligible six weeks ago while he had no symptoms and his PSA not rising.

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It is just shy of 2 years since hubby was diagnosed with stage 4 pc. since his last Dr visit 6 wks ago, his psa has doubled.

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How high does the psa have to get before symptoms such as bone pain appear?

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Dear Starlite, After almost 20 years as a patient I can't connect the dots between PAIN and PSA. When you said your husbands was at 5000 I was surprised. The highest I have ever heard and he dropped it to less than one. Wow! I have cancer in over 60% of my skeleton and the pain now is controlled by Xtandia and Tylenol. My PSA has never been higher than 39. I would say that the pain is not related to the PSA number only the cancers activity which in some cases is painless. At one time I had a large tumor near my left kidney and I felt nothing. Radiation got rid of the tumor. What does your Doctor say? Stay strong and keep fighting. Live long and be Happy. Jimmy

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Hi Jimmy, I never thought of cancer progressing without pain, I guess that's because of his past experience.
Thanks for your input, this is really good to know.

Starlite

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Dear Starlite, I did not mean to imply that I have always been pain free as my cancer continues to grow. I simply wanted to convey that the PSA had no reflection on the pain. Some of the worst pain I have experienced has been from side effects of treatment. I am seasoned enough now that whatever treatment I am on, if it is causing any major side effects, I ask my Doctor to try again. And we change treatment. When I first started almost 20 years ago we did not have much choice. Now we do! You sound like a very loving wife, that is half the Battle. Your husband is a lucky man. Jimmy

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Thanks Jimmy,
Another question. He was badly injured at work several years ago that involved his back and legs and although he was in
an extreme amount of pain when diagnosed, would the pc cancer have an affect on that as well.

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I shattered my right ankle in an accident in the middle of all these cancer treatments Surgery repaired my ankle. At no time did I feel as if the cancer had any impact on the ankle or vice versa. They were separate issues Thank God. Please Remember I am not a Doctor and these are good questions for your Doctor. Jimmy

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My husbands PSA has risen to 22.7 from 8.7 in 6 weeks, however, he is not experiencing any symptoms of recurrence nor any pain.

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@Starlite,
as information & experince show that there is no symptom , pain of reoccurance of pc. psa result quoted by u is itself shows every possibility of already reoccurance. ask urologist , he will recommend ct scan its report will clear all doubt. pls update us what is result.
gnk

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