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Should PSA Be Undetectable on Lupron

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Posted 8/28/2015 2:40 PM (GMT -5)
DH has been on Lupron for 7 months. PSA is a .2. Should it be undetectable by now? We have a call in to RO, but he's on Vacation until next Friday. That's a really long time. Thanks.
Posted 8/28/2015 3:42 PM (GMT -5)
When was his last shot? Is he due for another one? If I am reading your signature right, the Lupron should be starting to wear off soon and it's too soon for the SRT to be showing any results.

Waiting is a pain.
Andrew
Posted 8/28/2015 3:49 PM (GMT -5)
The last shot was one month ago. There was a glitch in the labwork, so we didn't get the PSA until today. They had to re-draw last week.
Posted 8/28/2015 3:53 PM (GMT -5)
I'm probably borrowing trouble. It just makes me nervous that the PSA has never been undetectable. Is 7 months of ADT too short a time to expect zero?
Posted 8/28/2015 3:54 PM (GMT -5)
Well, I am out of my depth here, so hopefully some one with better info with be along soon, but I am thinking it might be too early to put too much stock in the PSA number and waiting for your doctor to return isn't going to hurt. Likely there wouldn't be much adjustment in the treatment at this point.

I'm thinking you should get a retest and see where it is now.

Andrew
Posted 8/29/2015 10:29 AM (GMT -5)
There are no hard rules for hormone therapy..It's more effective on some patients than on others..You should have his testosterone level checked to be sure it's at or below "castrate" level..In some men, Lupron does not work as expected and "T" levels can stay above effective treatment levels. Casodex can be added to make the ADT more effective..At this point you should have a Medical Oncologist who specializes in Prostate Cancer or at least treats many PC patients directing your husbands treatment..
Posted 8/29/2015 10:53 AM (GMT -5)
According to Drs Strum and Scholz the objective of HT is to drive psa to .02 for at least 6 months. There are two books by Dr Strum, "Prostate Cancer Basics "and "Prostate Cancer Essentials" which explain the use of HT and the markers that show if its working or not. You should carefully read those two books as they will give more information than you will get on the internet or from your doctor.

Most ROs and Uros don't monitor key markers when giving Lupron. .2 is not an acceptable number and he should be seeing a medical oncologist specializing in prostate cancer.
Posted 9/3/2015 12:30 PM (GMT -5)
We just got a call from the docs office. They want to re-test. We are going back in on the 18th. Since the last test was done locally rather than at Emory due to a lab "error", they want it done in house for the sake of consistency. All they'll say at this point is to wait and see what the new lab work shows.
Posted 9/3/2015 12:41 PM (GMT -5)
It's annoying to have to wait, but a retest is likely the best thing at this point.

If at all possible you want to have all PSA tests done by the same lab using the same method. That helps keep lab variations out of the equation.

Do let us know what the new number is.
Andrew
Posted 9/3/2015 1:02 PM (GMT -5)
I agree with Fairwind on the testosterone test. If your going to have another PSA test getting the testosterone tested at the same time would make sense. You want to make sure that lupron alone is effective.
Posted 9/3/2015 3:18 PM (GMT -5)
At the end of April, his T levels were at castrate levels. My understanding is that they will be checking testosterone again. I found reading the links below a little disconcerting, all things considered. It seems anything more than undetectable during ADT might be bad news. In April his PSA was .4, so it had come down. I'm just concerned that is has never been undetectable.

http://www.renalandurologynews.com/prostate-cancer/psa-nadir-in-adt-recipients-the-lower-the-better/article/341235/

http://www.ncbi.nlm.nih.gov/pubmed/23245686
Posted 9/3/2015 4:37 PM (GMT -5)
I'm confused about "zero" and "undetectable" PSA levels while on Lupron. Doesn't a high sensitivity PSA test need to be used to measure below 0.1? My RO gives me lab orders for the standard test and seems satisified with a number of 0.1. Just curious about this.
Posted 9/3/2015 4:40 PM (GMT -5)
I'm not sure. When I started "googling", after that last PSA, those links are what I found. The standard tests we've been getting has shown the PSA to 2 decimal points, i.e. in April his PSA was .41.
Posted 5/24/2022 12:23 PM (GMT -5)
I’m curious about this as well. Please see signature then continue reading. 10 years out from original PC diagnosis we are at stage IV now. He has no symptoms but PSA got to .3 last October so we did a PSMA Pet Scan in November which showed regrowth on prostate bed (radiation resistant possibly) and 3 small/unmeasurable spots on ribs. One 8mm spot near rectal wall. Colonoscopy was clean in 2020 and MO sees no urgency in getting colonoscopy. Anyway, early December 21 PSA was .4. Started Lupron right then. January 22 PSA less than .1. April PSA less than .13 (done at two different labs so that’s what the range was a bit different. Cystoscopy in January and removed PC from bladder neck. Bladder was clean. Seems this crept up from prostate bed where the recurrence is. Recheck with scope in early May. Urologist saw something very small in bladder neck. Went in and scraped it out today. How can this be when he’s been on Lupron and also Xgeva for bones since 12/21? I could understand if the PSA hadn’t gone down or had gone up, but it has gone down. Awaiting biopsy results and praying this time that it is just scar tissue.
Posted 5/24/2022 2:02 PM (GMT -5)
look at the date on the conversation. you'd probably be better off starting anew thread
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