Is there an average and/or an expected drop in PSA after Lupron shot?

Thanks for the reply Jeff. Getting older has been most difficult as I become either wiser or more judgmental; not understanding how and why I’m so unfamiliar with the in’s and outs of this cancer.
When I was told to report to the oncology clinic and showed up, one of the nurses met with me to explain why I was transferred to the clinic from regular urology appointments. She went on: “ you’re here because we want to know why your PSA has been going up AFTER A Prostatectomy. “ She reminds me of the history: 6 months ago your PSA was 60, then a few months ago it rose to 100, then a couple of months after that it hit 112” I interrupted her to first say: “ I still have my prostate” She immediately replied: “ No you don’t. It says right here in your records that you prostate is missing “ ( strange choice of words, it would have made more sense to me is she gave me a date that it was removed ) She dives back into the records perhaps looking for that information. But she misinterpreted, I later found out; words to the effect that my “ pelvic floor was empty “ or something akin to that which were the words of someone in the process who read the so called definitive test which I’ve seen it mentioned here; which involves a PET and CAT SCAN done at the same time. I had that test conducted twice 3 months apart.
The first time it was ordered by my Urologist, who called me the minute he got the results, which was before I returned home after the test ( about 90 minutes after the test. I really like my urologist who was sincerely concerned that I hadn’t done anything since the cancer dx and warmed me that with a PSA OF 100 I very likely had the cancer Metastasize into my bones or other likely places that this cancer goes if not treated in some approved way ( hormone therapy and or radiation ) My doctor excitedly said I’m calling you about the results of you test which presents both positive news and a mystery. “ The cancer has not spread but that it hasn’t spread with a PSA of 100 for many months now ‘WHY HASN'T IT SPREAD’ is the mystery” I think you should consider hormone therapy at the minimum and we’ll redo the test in a couple of months.
I agreed to his suggestion already after discussing the results of the test with the assigned oncologist in the oncology clinic. BTW I really like him as well mostly because he was a great listener and he was aware of my fear of Lupron based on watching my Dad after he started Lupron injections. He suggested starting with a one month dose. In fact he ordered it while I was still talking with him; he called up to the Urology clinic to administer the one month dose. Turned out that the pharmacy didn’t have one month doses but it took over an hour to tell me I had to return for the shot once it was in house. Turns out that the message to notify me when it arrived fell thru the cracks of VA HEALTH CARE. It took well over a month before I was notified that it had arrived but there wasn’t an appointment open with my doc for three months and I had to make numerous calls for the VA to realize that the doc didn’t need to administer the shot. It was close to three months before I drove the 150 miles to get the shot which a nurse administered to the fatty part of my arm. By then my PSA reached 112.
They scheduled a retest of the PET/CAT scan which I was told by the same oncologist who approved the one month dose. He said your retest is almost the same as your first test so I recommend starting radiation. I asked about the type of radiation that seems to target the cancer only.
Meanwhile someone in the chain of command saw things differently and said that it was now in my bones.
Almost 4 months have passed and I have mostly been told erroneous info; like I have no prostate.
Meanwhile after 3 one month doses of Lupron, my PSA went from 112 to 15 seemingly Delighting everyone who has seen the 97 point drop. But I was also told by the doc who said I can rest assured that “ this cancer will be the death of you “ that I am not a Candidate for radiation! That makes no sense to me since the first oncologist wanted to target the cancer in the prostate.
This brings me back to the furst news of cancer " the size of a dime " in my Prostate.
i dont know who to believe. I've been to two very well respected cancer, hospitals, and the VA each one has a different take on what I should do making me even more confused.
Sorry for the Length of this post.
I'd like to hear what the people here in the Mayo Clinic connect form have to say maybe I can get some better advice than what I've been getting from the so-called professionals
Thanks again for replying!

Jeff,
As mentioned earlier: the read of the PET/CAT scan seems to be up to interpretation and no one explained exactly what has one doctor telling me that the scan there’s not much dif between the 1st and 2nd scan and the shadow areas can be spot treated the other doc said I’m no longer a candidate for radiation “ only if you’re in pain. I’ve had no new definable “ pain “ just the same old arthritis and degenerative disc pain. I actually thought that my records got mixed up with a different patient. I’d like a different facility to review them.
And most of the nurses and doctors reacted like a 97 point drop in PSA after two one month shots of Lupron. You think that it’s not enough. They added prednisone and Abiraterone to my daily meds. As mentioned I feel really good walking 4 miles a day and would increase the mileage, but my shins tell me no not yet.

More later

Great info Jeff! Allow me to share a few things that I learned from watching my Dad on Lupron.
Dad’s cancer was detected when he was 70 yo. I was detected at the same age. His doctor want to physically cut his manhood off. That was his last visit to that doc. The year was 1992. He started taking Saw Palmetto pills and seeing a urologist who did Prostate massages. I don’t recall the history of his PSA. That said his Doc told him about “ a new treatment “ called Lupron. He agreed to take it and there were changes in his PSA Immediately! That said no one mentioned to him anything about calcium supplements. His posture started changing rapidly and on the day he got his Lupron shot it was amazing to see a different man walk out before the shot and the man who walked after the shot. The fatigue and what I called Apathy factor changed his personality ( no one has mention any of these same possible side effects to me at all. I told my docs that I didn’t want to go thru what my Dad went thru. He passed away in 2014 at the age of 92 and after deciding that he was ready to die; “ I’ve lived a good life
. I survived a Nazi OW camp for nine months. I have a great family. I had a great life and I’m ready to go. He stopped taking Lupron. My mother wanted him to continue, but he hated the way he felt, and he hated what it was doing into his body.
I happened to be going to his doc and although uncomfortable as ($&@“ I think the prostrate massage helped now to just ask for one makes docs and staff look at me like I’m a sex pervert and have even suggested going to a sex worker. I’m getting off the main part of what I wanted to tell you about a drug that I was taking and asked the doc if he would RX it for Dad it’s called Provigil. He agreed and it worked well for the fatigue factor ( I’m also taking it now; asked for by me) it really works well for the tiredness and works fairly well for the apathy.
Dad eventually stopped taking because his choice was to sleep most of the day away while watching ( eyes closed ) Two and a Half men the calcium drain had this powerful man all bent over struggling to walk so he didn’t want to be stimulated to be awake during the normal waking hours. It was sad to see him suffer so I’m trying to learn from watching him.
But as mentioned I’ve gotten horrible advice from most doctors at the VA I’m taking what I think will help prevent the calcium depletion; a good tasting liquid and vitamin pills from the drug store not one of the doctors mention any of the pills that you mentioned. Which ones should I ask my oncology pharmacist to RX for me?
And I’d like to recommend Provigil or Nuvigil for fatigue. Strangely enough it helps me sleep when I go to bed around 11 pm. My bathroom trips are down to 1 or two occasionally more depending on what I consume during the day including a glass of wine on occasion.
I’d love to find a support group that’s got member similar to what we have here. Sadly the wrong group can have horrible consequences. One group I can to in Florida had 15 members all who had prostatectomies the leader of the group was strongly suggesting that I have mine removed. I stopped going to that group as I noticed that they all had complaints . The only man with do complaints was a 92 yo Jewish man who wanted me to play golf with him. I would have if I played golf which I never got into.
I do want to know about calcium meds and anything else that will keep me alive at least as long as my Dad that would mean 13 more years
Have you any knowledge about the prostate massage?
Thanks for educating me!
Much appreciated!

Thanks for the reply Jeff. Getting older has been most difficult as I become either wiser or more judgmental; not understanding how and why I’m so unfamiliar with the in’s and outs of this cancer.
When I was told to report to the oncology clinic and showed up, one of the nurses met with me to explain why I was transferred to the clinic from regular urology appointments. She went on: “ you’re here because we want to know why your PSA has been going up AFTER A Prostatectomy. “ She reminds me of the history: 6 months ago your PSA was 60, then a few months ago it rose to 100, then a couple of months after that it hit 112” I interrupted her to first say: “ I still have my prostate” She immediately replied: “ No you don’t. It says right here in your records that you prostate is missing “ ( strange choice of words, it would have made more sense to me is she gave me a date that it was removed ) She dives back into the records perhaps looking for that information. But she misinterpreted, I later found out; words to the effect that my “ pelvic floor was empty “ or something akin to that which were the words of someone in the process who read the so called definitive test which I’ve seen it mentioned here; which involves a PET and CAT SCAN done at the same time. I had that test conducted twice 3 months apart.
The first time it was ordered by my Urologist, who called me the minute he got the results, which was before I returned home after the test ( about 90 minutes after the test. I really like my urologist who was sincerely concerned that I hadn’t done anything since the cancer dx and warmed me that with a PSA OF 100 I very likely had the cancer Metastasize into my bones or other likely places that this cancer goes if not treated in some approved way ( hormone therapy and or radiation ) My doctor excitedly said I’m calling you about the results of you test which presents both positive news and a mystery. “ The cancer has not spread but that it hasn’t spread with a PSA of 100 for many months now ‘WHY HASN'T IT SPREAD’ is the mystery” I think you should consider hormone therapy at the minimum and we’ll redo the test in a couple of months.
I agreed to his suggestion already after discussing the results of the test with the assigned oncologist in the oncology clinic. BTW I really like him as well mostly because he was a great listener and he was aware of my fear of Lupron based on watching my Dad after he started Lupron injections. He suggested starting with a one month dose. In fact he ordered it while I was still talking with him; he called up to the Urology clinic to administer the one month dose. Turned out that the pharmacy didn’t have one month doses but it took over an hour to tell me I had to return for the shot once it was in house. Turns out that the message to notify me when it arrived fell thru the cracks of VA HEALTH CARE. It took well over a month before I was notified that it had arrived but there wasn’t an appointment open with my doc for three months and I had to make numerous calls for the VA to realize that the doc didn’t need to administer the shot. It was close to three months before I drove the 150 miles to get the shot which a nurse administered to the fatty part of my arm. By then my PSA reached 112.
They scheduled a retest of the PET/CAT scan which I was told by the same oncologist who approved the one month dose. He said your retest is almost the same as your first test so I recommend starting radiation. I asked about the type of radiation that seems to target the cancer only.
Meanwhile someone in the chain of command saw things differently and said that it was now in my bones.
Almost 4 months have passed and I have mostly been told erroneous info; like I have no prostate.
Meanwhile after 3 one month doses of Lupron, my PSA went from 112 to 15 seemingly Delighting everyone who has seen the 97 point drop. But I was also told by the doc who said I can rest assured that “ this cancer will be the death of you “ that I am not a Candidate for radiation! That makes no sense to me since the first oncologist wanted to target the cancer in the prostate.
This brings me back to the furst news of cancer " the size of a dime " in my Prostate.
i dont know who to believe. I've been to two very well respected cancer, hospitals, and the VA each one has a different take on what I should do making me even more confused.
Sorry for the Length of this post.
I'd like to hear what the people here in the Mayo Clinic connect form have to say maybe I can get some better advice than what I've been getting from the so-called professionals
Thanks again for replying!

I'm stage 4, sadly, 4+3. I've been to the three best facilities for cancer in the country. I'm being treated at Sloan Kettering and got second opinions at Mayo and MD Anderson. They all gave me the same information on the treatment which is good. The end goal was to get radiation for the prostate and the hip where the cancer has gone.

Interesting is that my PSA was only 3.6 after being 1.7ish and that's what prompted the MRI. Less than a PSA of 4 is usually a wait and see thing. I was stage 4 at that point.

With me, before Lupron and abiraterone, they gave me an oral medication to shut the testosterone receptors of the prostate cancer down. Lupron will raise the testosterone levels in your body initially and that's why they gave me the first medicine, can't remember the name but starts with Bi ( I can find it if you want me to). You don't want to be feeding the cancer if you can help it.
I will be on Lupron and Abiraterone for a total of two years and if I make it that far, they will take me off of those and wait and see.

I'm currently completing my SBRT radiation treatment with 5 sessions for the prostate and three for the hip. The radiation isn't real bad. The first session of the prostate, I felt a burning down there and after subsequent sessions, Aleve seemed to fix things. The hip, I haven't felt anything after two sessions. The prostate sessions lasted about four-five songs on the music and the hip was two or three songs for each session.

If in doubt, or for the hell of it, go to the best place you can find to get a second or third opinion. For me, each opinion cost Medicare about $900 and i had to pay travel expenses.
Why did i get second and third opinions, because I didn't want to be on my death bed wishing I should have done more.

BTW, the second opinion idea came from people here in this web site and it was the best thing I could have done. Takes away all doubt of the treatment I was receiving.

Good luck and don't assume the doctors know everything,