PSA in 20's

Palyn,
Your husbands case is definitely appearing hormone refractory if after two months he is still registering a detectable PSA. He needs to be on a 2nd line hormonal therapy and if his oncologist isn't on board with that then your husband needs to expand his medical team. I know of no reason that "plateauing" is a good thing when the PSA is so highHe can still do very well but this development indicates that this is not going well.

At this point I would also see is your husband can get DES, Keto, Nilandron, Abiraterone or Provenge as well but there may be better options right now.

My treasurer at my UsTOO group had the same thing happen last December. He tried DES, Nilandron and was placed on Provenge. His PSA is down to 2, but he may be headed to chemotherapy if the Provenge does not work. But as of now he looks good and is a wonderful man. He just completed his run on Provenge and it is still too early to tell what effect it has had on him. He is getting his next PSA after Christmas.

Don't panic but rather start questioning everything. There is still plenty of hope...

Tony

This is just my OPINION, but I question the wisdom of intermittent treatment with metastasized Gleason 9 PC.. To me, the best course of action is to get the PSA down as far as possible and keep it there..Do you know his PSA when he started his HT vacation? How long has he been on HT?

Sometimes Lupron is combined with other drugs like Casodex and Avodart to completely eliminate the effects of any residual testosterone..

At this point some men are treated with one of the old-line PC therapies, DES, an estrogen compound..Even refractory PC can sometimes respond to this positively..The risks are increased, but more PC patients die from heart attacks than any other cause anyway, so you just have to play the odds....Your oncologist may very-well be right. I would not jump to conclusions just yet...Best of luck to you both...

Hi Palyn,   Has your husband had a testosterone test? HT main aim is to lower the testosterone in the body, and in the process it also affects the PSA. However, PSA alone cannot rule plateauing. Also if your husband is only on a single blockade drug (LHRH agonist Lupron), according to Myers reports, success is still possible by adding other blockade drugs such as an Anti-agonist and a 5- α reductase Inhibitor. LHRH agonists alone put the patient on TIP (castration levels of serum of total testosterone <50 ng/dL ). There will be still plenty of testosterone to feed cancer cells, therefore promoting a higher PSA. ADT3 stands for Androgen Deprivation Therapy Triple blockade. That is a cocktail of drugs working at the same time, with the aims of reducing testosterone in the body to the lowest level possible, at <10 ng/dL . Once PSA or T tests increase, these drugs are given to patients on higher doses, before Hormone refractory prostate cancer is ruled . A good example is Myers protocol were he puts his patients on 150/200 mg/daily anti androgen Casodex, aiming to get those low low levels. Hope these helps you in understanding other possibilities to discuss with your oncologist. Take care Baptista Post Edited (Baptista) : 11/25/2010 5:43:29 AM (GMT-7)

Hi Palyn,
According to a study done By Oliver Sartor, M.D., a respected hematologist at LSU Medical Center, the definition for androgen-independent or hormone-refractory prostate cancer involves a patient with progressive prostate cancer and serum testosterone of less than 50 ng/ml (castrate level).
In your husband case the rise in PSA with a low testosterone may indicate progression of the disease, therefore HRPC.
A withdrawal of the anti-androgen usual responds to lower the PSA. Oncologists call it AAWR. The mechanics behind are theoretically assumed that androgen receptor of cancer cells will mutate in time so that, a withdrawal of anti-androgens bound to the receptors, will stop feeding the cancer.
You may find in the net information regarding your question by searching with the string; “How Should We Treat Hormone-Refractory Disease”.

Hope you get more answers to your quest.
Wishing you both the best
Baptista