PSA doubling time

Need more info, how long were you on Lupron?

Difficult for the group to respond without your clinical history - diagnosed, prior treatment....age, any health issues (other than PCa!)

I've attached mine....

That being said, your PSADT is a clinical history of treatment in your near if not immediate future.

I’m a fellow Gleason nine patient. We’ve commented on each other’s threads before.

Depending on what your PSA actually is, it might be time to get a PET-PSMA test to see where it’s showing up again. You may find yourself in a situation somewhere to me where they told me that if my cancer reoccurs, they may have to look for it and play “whack an mole” all with it with IMRT sessions. Yes, that’s the actual words that my surgeon and oncologist used!

I don’t recall if you were getting doublet therapy before, but it might be time for that as well. That would mean Lupron or ORGOVYX is a first generation ADT and ZYTIGA for second generation therapy.

If you haven’t had decipher testing yet, this might be the time to get that as well. You could identify gene mutations that would identify other therapies that could be used on your journey.

All the best to you. Bob

If accurate that is indicative of very aggressive disease that will likely be metastatic if not already. I'm assuming that you've had your prostate removed sometime in the past? If it were me I would be talking with a medical oncologist, not urologist, about throwing the kitchen sink at it.

3.8 Years in. Started out 11/2020, Gleason 8, PSA 118. Low point 5/2023, PSA 0.13. Started slow climb upward, checked every 3 months. It's at 1.18 on my last lab 2 weeks ago. Worried? Yes. Grateful? Yes. PSA Worries are a part of the Advanced Prostate Cancer Life Path. Grateful for My NCI-Designated Cancer Center Cancer Team that guides me along this path. They made adjustments (Clinical Trial) by the time my Labs made it to My-Chart. Lesson learned. My NCI Oncologist calms me down, discusses what next in a way I can understand it, keeps focus on Quality of Life (QOL) issues. QOL is something I can do and do well. Adds positivity along may Life Path.

4 years ago PSA 28, Gleason 9. 6 weeks radiation (no surgery) followed by 3 years of Lupron. I've been (happily) off Lupron for more than a year.

Also, in 7 months I turn 65 (Medicare! Whoopee!)

I did a genetic test which showed nothing.

2 years ago PSA was 0.06
1 year ago 0.1
Yesterday 0.634

If only my retirement portfolio performed so well.

And thanks to all for the comments. I guess the question is which mole to whack, and which instrument to whack it with, and when.

Greetings
It may, or may not be, as bad as it seems.
I am in a similar situation.
On 08/22/23 my PSA was < .01.
12/08/23 psa .03
02/02/24 psa .06
04/22/24 psa .10
07/26/24 psa .17
I used the MSK doubling time calculator and the doubling time from 08 to 07 was 1.8 months, (not good).
However the doubling time taken individually from month to month according to the calculator was (.7), - (1.8)-(3.9) and 4 months respectively, which shows that it is still getting worse but at a reduced rate.
You may want to use the same logic.
Best Wishes

At that PSA, .634, have you and your medical team discussed imaging with one of the PSMA PET scans? It may locate where the recurrence is an inform a treatment decision.

Others things to discuss, doublet and triplet therapy - https://dailynews.ascopubs.org/do/would-you-use-doublet-therapy-and-not-triplet-therapy-patient-newly-diagnosed-mhspc both can be for defined times vice continuous.

If you have not already, bring a medical radiologist and medical oncologist into the discussion, preferably ones with extensive experience in PCa.

As I have said in other posts, the SEs of ADT are well known and may vary in each of us for a variety of reasons. There are three things you can do to manage or mitigate:
Diet
Exercise
Manage Stress.

Your medical team can help with others, ask...

Neither while on the 18 months of Lupron and 12 months of Orgovyx did the SEs interfere with my life, They were annoying, some of the actions I took were in retrospect, funny...I never ran the heater in my car, thankfully with dual climate control my wife was able to ride with me. Friends wondered why I didn't swim in the heated pool, once on a work trip a colleague reached to turn the AC down in our car, I told him I'd have to kill him if he did...

During the 12 months I was on Orgovyx wife and I went to Iceland for two weeks and did the Ring Road,. We went to Oregon with friends for two weeks, Crater Lake, Columbia River Valley, Mount Hood, North and Central Coasts. I went skiing in Colorado with friends, rode in the Gamin Unbound 50 with my sister, a 50 mile gravel bike ride through the Flint Hills near Emporia, KS. Most days I went o the gy, rode the indoor bike, lifted weights, swam. I did the yard work, walked the dog, went to several concerts...

For those of us "fortunate" enough to live with this disease (vice the 30k or so here in the US who die of it every year), we make choices that enable us to do so, balancing quality and quantity of life. I've been fortunate to have those choices for 10+ years, of which only three have been actively on treatment, that's a lot of living.

Tonight my wife, daughter and her boyfriend are going to see Moulin Rouge at the Kansas City Music Hall..

Kevin

I prefer the MOTOWN all stars as we’re both from DETROIT- sugar pie honey. LOL