HT One Month Status

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Bob Caron - 07 Jul 2006 21:18 GMT

After failed EXBRT, PSA at 6.2 started HT with casodex and Lupron. after
one month PSA at 0.6-Testosterone at 25, are these numbers good? doc
says testosterone will come down further. Was also put on OS-Cal
calcium/vit, D, and Omega 3.
Are my numbers good? for one month on HT.

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Steve Jordan - 07 Jul 2006 21:53 GMT

On July 7, Bob Caron inquired:

(snip report on test results)

> Are my numbers good? for one month on HT.
>

I think so, but why not ask the medic?

They look like a good start.

PSA =/< 0.05 ng/mL is considered undetectable (UD). The ultrasensitive
PSA test is called, "PSA, Post-Prostatectomy." The CPT (test) code is
11062. UDPSA for at least a year should be the criterion for suspending
ADT and moving to intermittent ADT.

T < 20 ng/dL should also be a target.

See the Prostate Cancer Research Institute at
http://prostate-cancer.org/index.html

Regards,

Steve J

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Beverley - 07 Jul 2006 22:58 GMT

How long has it been since you had the EBRT?
Bev

> After failed EXBRT, PSA at 6.2 started HT with casodex and Lupron. after
> one month PSA at 0.6-Testosterone at 25, are these numbers good? doc
> says testosterone will come down further. Was also put on OS-Cal
> calcium/vit, D, and Omega 3.
> Are my numbers good? for one month on HT.

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Steve Jordan - 07 Jul 2006 23:24 GMT

On July 7, Beverley asked Bob:

> How long has it been since you had the EBRT?
>

Good question! Wish I had asked it.

Along with this: which *type* of EBRT? 3DCRT? IMRT? IGRT? Other?

It appears that the radiation was not administered to the PCa cells. In
other words (IOW) the target was missed -- if the rad onc even had a
certain target. I have to wonder whether it was the rad onc who failed,
not the tx.

Regards,

Steve J

"We must tailor the treatment to the nature of the disease. We must
listen to the biology."
-- Stephen B. Strum, MD

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Steve Kramer - 08 Jul 2006 00:08 GMT

> After failed EXBRT, PSA at 6.2 started HT with casodex and Lupron. after
> one month PSA at 0.6-Testosterone at 25, are these numbers good? doc says
> testosterone will come down further. Was also put on OS-Cal calcium/vit,
> D, and Omega 3.
> Are my numbers good? for one month on HT.

On the face of it, Bob, it looks pretty good. I do not know when you went
on RT. I assume it was shortly after you were dx'd a couple of years ago.
However, I remember your PSA progressed steadily since, but I didn't know
that it went to 6.2 or that you started HT. Assuming you started HT in
June, or late May, I would think that a current PSA of 0.6 is just about
perfect.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Non Illegitimi Carborundum

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Bob Caron - 08 Jul 2006 13:16 GMT

Additional Info;
Biopsy: 3/29/2004 12 Needles. left side=10% of one core positive.
Gleason 6, (3+3) Stage T2C. (PSA 7.2)
EXBRT 7/2004
PSA 1/1/2005 1.1 Nadir
PSA 9/1/2005 2.7
PSA 11/1/2005 2.7
PSA 1/1/2006 3.4
PSA 1/19/2006 3.6
PSA 2/15/2006 4.2
PSA 4/15/2006 6.1
PSA 5/15/2006 6.2
Bone Scan, CT Scan, & Prostascint, all Negative.
Salvation Surgery, not an option. (heart condition)
Cryo? possible. Clinical Trial: was rejected due to heart condition:
trial is at the University Of Maryland, consist of four months chemo
using Doxorubincin and Taxotere, followed by HT.
Started Casodex and Lupron on June 5, 2005. Lab. work on July 3,
resulted in readings of PSA 0.6 and Testosterone of 25.

>> After failed EXBRT, PSA at 6.2 started HT with casodex and Lupron.
>> after one month PSA at 0.6-Testosterone at 25, are these numbers
[quoted text clipped - 8 lines]
> you started HT in June, or late May, I would think that a current PSA
> of 0.6 is just about perfect.

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Alan Meyer - 10 Jul 2006 04:56 GMT

> Additional Info;
> Biopsy: 3/29/2004 12 Needles. left side=10% of one core positive. Gleason 6,
[quoted text clipped - 15 lines]
> Started Casodex and Lupron on June 5, 2005. Lab. work on July 3, resulted in readings of
> PSA 0.6 and Testosterone of 25.

Bob,

Let me begin with the standard disclaimer that I'm not a doctor
and my advice ain't expert. Your doctor will know a lot
more about this than I do.

The rapid rise of PSA after radiation may indicate that your
cancer had already metastasized, which would be why the
radiation failed. It is very common for very small metastatic
colonies of cancer cells to establish themselves without being
visible on the bone, CT and Prostascint scans.

Ron Figueroa had a rapid rise after his radiation treatment
and it was soon discovered to be due to metastasis. Some
others have had very slow rises - possibly indicating that
there was a local failure rather than a metastasis.

But perhaps your failure is local. I don't know and don't know
if anybody can say for sure if the scans are still negative - which
they will surely be on hormone therapy.

The numbers you got look good to me. As I recall, my numbers
on HT were just like yours after one month. Within a few more
months I was below .2 PSA, which was the lowest that my
radiation oncology lab reports. I think my testosterone
eventually got to around 20, but no lower. Others have had
lower readings and perhaps mine would have gotten lower
if I had been on HT longer.

Hopefully, you'll be able to manage the cancer with HT for
a long, long time.

Good luck.

Alan

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