Lupron, what do you think.
Talking to my oncologist / radiologist doctor s my PSA has risen slightly. Love my doctor. She's a hell of a doctor and very smart. I tlod her I really didn't want to take Lupron for my PSA. There is no indication that there is much that had gotten outside the prostate from my surgery. My PSA has risen from .14 to .26 last time I tested. There was a spot on my MRI but it appears to have been a shadow. Anyway, we're discussing treatment and we're talking about radiation. The surgeon who did the operation and removal doesn't think I need Lupron. The oncologist associated with his practise also doesn't think I need Lupron. My local oncologist, Harvard trained and highly regarded wants to have the discussion about Lupron. A small dose, 3 month I believe. What doyou guys think? Just asking your thoughts as some have had the treatment. My doctor is really great doctor but I just don't like the odds of side effects from Lupron added to radiology.
“My PSA has risen from .14 to .26 last time I tested. There was a spot on my MRI but it appears to have been a shadow.”
0.14-0.26 sounds really high to me for someone without a prostate. Im not an expert, but the numbers i read when RP guys report after surgery seem to have more zeros in it. Like 0.014-0.026? Look into that.
Also MRIs are no good in picking up small stuff. Have you asked about the PSMA-PET? Thats what guys that have recurrance get after RP to try and pinpoint the recurrance. Many times they can zap spots if found. Otherwise they have to radiate an area like the prostate bed, or farther out to include lymph nodes if they think they are involved. Ive heard of guys still maybe effecting cure or if not, still achieving a very long period of very good life.
Im certainly not a top expert, but what i wrote is kind of the general gist
I can tell you, i had two MRIs and neither one saw any cancer at all. And the second one they knew exactly where to look, because it was after the positive biopsy.Thanks for the response. I also had a pet scan done back in January I think. Nothing there apparently. But I appreciate the thought. I trust my doctors' judgment but I'm leery about Lupron. She is open to discussion but wanted to know what others thought. Thanks again..
My post op and post radiation PSA scores have been great for the past few years 0.02 Now out of no where suddenly my PSA has been rising to 0.38 and most recent 0.45 so suspect the next visit with MD will center on some kind of treatment as well.
I was on Lupron prior to radiation and it was the so called "6 month shot" candidly the impact lasted 14 months - hot flashes, not sleeping and weight gain. A bit of hell to say the least. Not quite sure what next steps will be but suspect it will be a PSMA-PET to start -- Time will tell. I am thinking rather than a urologist doing Lupron I might be more inclined to have a conversation with a medical oncologist for a more comprehensive overview of a potential path ahead . All thoughts are welcome ....Dennis(ProstateCancer.net TEAM)
Hi
. I want to echo about the PSMA scan, which is a specific type of PET scan. It is the gold standard at finding recurrent prostate cancer (see here: https://prostatecancer.net/clinical/psma-imaging-scan and https://prostatecancer.net/treatment/psma-targeted-pet-imaging for more information). It can also now be combined with a radioligand to specifically target the cancer. I don't know what this would mean for whether androgen deprivation therapy would be necessary, but it might offer options. You may also want to ask you doctors about relugolix (Orgovyx), which is a relatively new pill form of androgen deprivation therapy. As this article notes, it has fewer cardiovascular risks and "In addition, men in the relugolix group also did substantially better on several other measures, including being able to return to normal testosterone levels within a few months of stopping therapy:" https://www.cancer.gov/news-events/cancer-currents-blog/2021/fda-relugolix-prostate-cancer-androgen-deprivation-therapy. Hope this information is helpful and please feel free to keep us posted on how you are doing. Best, Richard (ProstateCancer.net Team)
