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Prostate Removed--Rising PSA: What are my options?

Prostate Cancer | Last Active: Apr 28 6:53am | Replies (21)

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@rnpalarino1

Hello Everyone:

First thank you for your replies and support. This is a great group.
Second I want to provide an update on my current status and get your opinions on next steps.
My prostate was successfully removed in 2021. For two years my PSA numbers were insignificant. And I had no problem with urination, and sexual activity decreased but nothing a 77 year old man could not live with.

In 2023 the numbers began to rise about every 4 months; .15, .29, .53 and now .92. MD Anderson, Jacksonville, did a PET CT Prostate GA-68 Initial Staging Scan and did not find any cancer.

Since they cannot find any cancer there is no plan for radiation, however my oncologist, Dr. Zaiden, recommends I begin hormone treatments (Relugolix) to bring my testosterone down to starve the cancer.

As many of you know Relugolix is a relatively new treatment, a pill, which can be given for a period of time and stopped if necessary with good results. There are some after effects of the medication which concern me.

I have given some thought to not taking the Relugolix and take my chances but wanted to get your opinion.

Thanks again

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Replies to "Hello Everyone: First thank you for your replies and support. This is a great group. Second..."

web265 | @web265 | Apr 23 7:09am

Hey @rnpalarino1
I've had a similar journey so far except when my PSA started to rise, we did salvage radiation therapy along with Relugolix. I'm a little younger though at 62.

My PSMA PET scan was negative as well but the feeling was that there had to be some cells still growing in / near the site of the prostate bed. My PSA had started to rise within 6 mos of the operation.

I'm in 2 years with the meds and this point and my sense is from reading and my experience that Relugolix is very effective at starving cancer cells. My PSA is back down to < 0.006 (knocks wood) The side effects are well documented and seem to vary in intensity person to person. My saving has been to keep moving, walk, run, work out, motorcycle and I'm still working. I do get fatigued in the afternoons. If I'm not doing anything a nap helps.

Having said that, I'm about to start a treatment holiday after 2 years. My feeling and the feeling of the med team is that the Relugolix is so effective, we really don't know how much cancer, if any, is left in my system. Since the meds started with the radiation, did the radiation do it's job or is the Relugolix keeping the PSA down? We won't know till I go off and see what happens. I can always go back on if needed.

Having been through the drug treatment once, if I had to do it again? (..and I may) If it kept me around to play with my grandkids a few more years, yup. I'd do it again. It's a very personal decision though.