Prostate cancer treated with Leuprolide

It just gets better and better

is it possible to get all the Lupron comments on one page so I could print them and show them to my doctor??

Don, suppression of testosterone is the standard next level of treatment for prostate cancer that has recurred after first or first and 2nd level treatments have failed. By first and second I mean surgery and/or radiation. If you still have PSA after the prostate area has been aggressively treated the assumption is that enough cells have accumulated somewhere outside the prostate capsule to be able to create PSA, in other words, a tumor, however small. Since they don't know exactly where it is, they treat you systemically by depriving the prostate cancer cells of their primary growth driver, testosterone. Some men have minimal side effects, some serious. Its very subjective. Your doctor should have explained this to you as well as the fact that their are no clear alternative treatments available now but some are emerging. Try to exercise as much as you can within reason. Ask for help with any depression if it is a problem. Here is one website that covers many topics related to advanced prostate cancer: http://malecare.org/advanced-prostate-cancer/
Here is another and there are more: http://www.yananow.org/Experiences.shtml
By all means get your PSA tracked as often as advised and avoid any temptation to self-treat based on unproven anecdotal evidence.
I've been treated twice, surgery and radiation, and it looks like I'm on my second recurrence. I've had low testosterone without getting Lupron and I know how it feels, in my case awful. But, considering the alternative, its worth working with it. Let me know how you're doing.

I had an appointment with a medical oncologist this morning and we went over all the options. My psa at the last test was 30 which means that is it still rising, although some psa's have actually gone to 10,000. I m going to have a bone scan and a CTScan, last ones were a few months ago next week. Then I will meet with her and see what she suggests based on the results. I could start with 1 Lupron shot and see how that works. Then meet with the urologist and perhaps go on a regular schedule with frequent psa tests, etc.She said the worst side affect for most men is hot and cold flashes.(at last we get to experience first hand what women go through). Some are very strong and others had minor problems. There are pills for that, she said. Since I also have afib I am used to frequent tests to gage the affects of various medication levels. Since I was seriously dizzy with gabapentin that is a real possibility here, she said.

There is the idea of 'Watchful Waiting' but it sounds like with a rising PSA treatment is advisable. But at the end of the day its your call after you get the info. I encourage you to check some of those support groups. Keep us in the loop.

HAVE YOU HAD A PROSTATECTOMY, FROM MY HUSBANDS EXPERIENCE THAT HE HAD A VERY AGRESSIVE PROSTATE CANCER MY SUGGESTION GO WITH LUPRON AND SEE IF YOUR PSA LOWERS. MY HUSBANDS IS 0.07. THIS MEANS UNDETECTEBLE. WISH YOU ALL THE LUCK . FLOR

Thanks.  Instead of surgery I had 43 days of radiation.  All was well (from 2011 ) until this summer when the psa for some reason went from 8 to 20 to 31.  I met with a medical oncologist yesterday and we decided to do bone and CT scans next week and then regroup.  She said that hot flashes were most bothersome but we could start slowly with lupron and see how that goes. 

@donnelson, it is encouraging that you had five years of confidence that your prostate problem was manageable. I hope you also can be confident that your rising PSA reading last summer may not have been caused by a recurrence.

These discussions tend to refer to PSA tests as definitive for the disease and useful in tracking its progress over time. This is unfortunate. To put the PSA in proper perspective, here is a link to an education "tool" published by the American Urological Association last year: https://www.auanet.org/common/pdf/advocacy/grassroots-toolkits/DPCBooklet.pdf.

Note in particular this statement: "Most high PSA results are false positives (about 70 percent). Also, there is a small chance you may have prostate cancer even with a normal PSA test (about a 1-2 percent risk)."

This paper lists five major non-cancer causes of high PSA. I've had four of the five. They elevated my PSA repeatedly, but after nearly 20 years of up-and-down PSA readings, no cancer has been diagnosed.

When I passed my 70th birthday, my urologist stopped taking the PSA, in keeping with Urology's reigning principles of treatment. He said that, at my age (now 80), he wants me to avoid the false hopes and false fears that the PSA causes so often. Like your urologist and oncologist, he relied on other tests and examinations that (so far) confirmed his no-cancer diagnosis.

I sincerely hope that your bone and CT scans show positive results and that you won't have to worry about the risks of taking Lupron.
Martin

Follow the oncologist's advice. A rising PSA post treatment is indicative of a likelihood of treatment failure and should be taken seriously. There is a lot of disagreement among urologists and oncologists regarding the fairly recent changes in recommendations for routine PSA testing. Regardless of that, it is one animal when you have never been diagnosed with prostate cancer and another when you have been diagnosed with it and treated for it. A clean bone scan is not proof that you don't have a recurrence. It just means that not enough cells have amassed in bone to generate PSA. Follow the protocol as dictated by your oncologist, or not. If you don't, ask to know the risks.

Hi all, Incredibly informative conversation happening here, and perhaps somewhat confusing with regards to PSA guidelines.

@predictable, I appreciate the American Urological Association reference you provided. It is very well articulated in plain language. However, this information is specific to prostate cancer screening, not PSA reading with respect to monitoring for recurrence.

Here are some references about post-treatment monitoring from Harvard Medical School:

- Post-treatment monitoring http://www.harvardprostateknowledge.org/post-treatment-monitoring
- How to handle a relapse after treatment for prostate cancer http://www.harvardprostateknowledge.org/how-to-handle-a-relapse-after-treatment-for-prostate-cancer

I'd like to quote the opening paragraphs of the first article:
"Today the prostate-specific antigen (PSA) screening test is often the first indicator that cancer may be present in the prostate gland. The usefulness of PSA testing, however, is not confined to the initial screening and decision making. After treatment, PSA monitoring is the primary tool for measuring treatment success and for detecting early signs of cancer recurrence.

The PSA value and its velocity (its rate of change over time) are valuable tools for assessing options for further treatment. You will continue to have regular PSA tests throughout life as an early-warning system to detect residual or recurrent disease. Let’s not forget that a significant percentage of men with a normal PSA will have an abnormal digital rectal exam (DRE), and both should be done!"

@donnelson it sounds like your oncologist is keeping a close eye on things. As a woman, I can tell you hot flashes are bothersome, but manageable. Oops did I just give away my age?