Update May 14

We saw the new oncologist for hubby's PSA report and Lupron shot. He gave us a full update and reviewed all our recent treatment decisions.

Bad news- PSA doubled (again) since last one in Jan.- now up to 0.08. I know that isn't really high, but it is rising FAST!

Hubby and doc decided to wait to September to start Casodex----- because he is starting on Prolia due to his bone density that we recently discovered (thank you to the new doc for ordering a density test). Doc said starting both close together could put hubby on the floor with bone pain. He already has some due to the Lupron (and possible mets) and doc wants to space things. I agreed. The switch back to Lupron (uro had switched him to Eleguard last year), is also a plus - according the hubby. He never trusted the Eleguard.

Doc also said if PSA doubled again by Septemeber, he will consider ordering other tests.

Sorry- Forgot to include signature. He is 5 years post diagnosis and Da Vinci surgery. Gleason 9 Been on Lupron/Eligard since just after surgery. PSA had dropped to 0.00 and stayed there for about 3 - 3 1/2 years. Started rising Jan. 2016 (same time the uro switched to Eligard= know they are supposed to be same). I have been uncomfortable with how the uro managed his care for a couple of years now. Glad he agreed to switch to an oncologist (uro had told him he would not consider ANY other additional/different therapies for at least another year or two= and communicated that through his physician assistant, also had refused to order bone density scans). We really like the new oncologist. Yes- he has been on calcium for several years and recently added vitamin D3.
Doc said some people have severe bone pain when starting Prolia, and some have it with Cassodex at first. That's why he didn't want to start them together.
I'm aware that 0.08 is considered very low, but recently read study of large group of G9 men- of those that reached 0.04 (or higher) 90% went on to reach 3.0 'trigger' for further treatment in relatively short time. Recommended considering adding more aggressive therapies earlier rather than waiting.

No- uro didn't, but the new medical oncologist insisted we consult with one prior to starting treatment. We went but already knew we would probably not consider radiation. Hubby had to have 3 follow-up surgeries within a year and a half after Da Vinci, to re-open bladder due to scaring blocking it. Radiation oncologist said he could 99% guarantee hubby would have major bladder scaring from salvage radiation. New oncologist agrees it is not a good option. As of right now no mets showing on most recent scans. Had positive lymph nodes after surgery, though. Doc (and I ) suspect micro mets- most likely in bone or liver (see previous posts). This doc plans to order regular (probably yearly) scans. If the Cassodex doesn't help we will talk about chemo.