The PSA will go down immediately. You don’t say How high at the PSA was because that is a factor. As the previous person said within a 2-3 months it usually becomes undetectable. Undetectable is considered < .1.
PSA was 6.3 when he recently started Orgovyx. Before surgery in June PSA was 10. Six weeks after surgery PSA was 1.9. Rose to 4.7 at 12 week check. Last week it was 6.3 and he started on the Orgovyx 3 days ago.
PSA was 6.3 when he recently started Orgovyx. Before surgery in June PSA was 10. Six weeks after surgery PSA was 1.9. Rose to 4.7 at 12 week check. Last week it was 6.3 and he started on the Orgovyx 3 days ago.
This is unfortunate. Before going on Orgovyx was a PSMA PET scan done? You want to do it when the PSA is high (above .7). Orgovyx Can take it down to undetectable and then you can’t see where metathesis are.
It would seem that salvage radiation would be one of the first things they would do, But it may be too late for that as high as the PSA has risen.
Hopefully you do not have just a urologist treating him. It definitely would seem like you should get a second opinion from a center of excellence. Something’s going wrong and you need to have aggressive treatment, But you need to see a group of doctors that can figure out what’s going on.
NOTED limit: the data preceded the recent < 3 yr general use of PSMA PET/CT scans. IMHO a G8 or 9 pre 'scans' may harbor more extracapsular prostate extension (ECE) . The 'significant' but only modest difference was beneficial to biomarker positives with LADT. If scanned negatives might have been excluded
it begs the question if the 'significance' might have dropped to a margin of error range borrowing from social science.
I have been on ORGOVYX 2 months- went from PSA of over 50 to PSA of .05 in 6 weeks or so..doc wants me to start Nubeqa now since I could not tolerate Erleada ( 9 dyas and quit it) ...so I am wondering if stopping ADT in 9 mos.might be as effective as 1 -2 yr...and if Cancer returns, maybe it will still be responsive to ADT therapy
The current protocol is throw everyhting at aggressive prostate cancer early on ( ADT for 12-24 mos + radiation) and hope for long period of remission/"cure"
Lots of guys on here who have been in this war for 5-10 yrs and know alot more than me..I can imagine a recurrence is pretty shattering...like being parolled for many yrs, then returened to prison.
This is unfortunate. Before going on Orgovyx was a PSMA PET scan done? You want to do it when the PSA is high (above .7). Orgovyx Can take it down to undetectable and then you can’t see where metathesis are.
It would seem that salvage radiation would be one of the first things they would do, But it may be too late for that as high as the PSA has risen.
Hopefully you do not have just a urologist treating him. It definitely would seem like you should get a second opinion from a center of excellence. Something’s going wrong and you need to have aggressive treatment, But you need to see a group of doctors that can figure out what’s going on.
He had PSMA before surgery and two lymph nodes lit up so we knew about those and the surgeon removed those and also found another cancerous node in the bilateral dissection. We finally got the insurance company to cover a new PSMA PET and that is scheduled to happen in a little over a week. In the meanwhile he just began the Orgovyx. Also has been referred to a radiologist. We are under the care of UCLA Urology Oncology and they are great. Oncologist said start the Orgovyx now to stop any activity and we’ll get a more specific treatment plan after the PSMA PET. He referred to radiology to get things going. I’m sick with worry.
This is unfortunate. Before going on Orgovyx was a PSMA PET scan done? You want to do it when the PSA is high (above .7). Orgovyx Can take it down to undetectable and then you can’t see where metathesis are.
It would seem that salvage radiation would be one of the first things they would do, But it may be too late for that as high as the PSA has risen.
Hopefully you do not have just a urologist treating him. It definitely would seem like you should get a second opinion from a center of excellence. Something’s going wrong and you need to have aggressive treatment, But you need to see a group of doctors that can figure out what’s going on.
He had PSMA before surgery and two lymph nodes lit up so we knew about those and the surgeon removed those and also found another cancerous node in the bilateral dissection. We finally got the insurance company to cover a new PSMA PET and that is scheduled to happen in a little over a week. In the meanwhile he just began the Orgovyx. Also has been referred to a radiologist. We are under the care of UCLA Urology Oncology and they are great. Oncologist said start the Orgovyx now to stop any activity and we’ll get a more specific treatment plan after the PSMA PET. He referred to radiology to get things going. I’m sick with worry.
You are definitely at the right place. You didn’t mention the PSMA PET scan earlier, but it’s great to hear they’re doing it.
You really have to wait to see what they find with the pet scan.
One thing you didn’t mention is his Gleason score. That is a critical piece of information that tells us more about what treatments will work and how long they will work.
While it does sound like the rising PSA is a major problem. You have to realize that treatment these days can handle what you are seeing quite easily. This isn’t time to panic. There are so many treatments and you are just beginning what could be a very long progression Free survival. I know many people that have had very serious cases Of prostate cancer and are still around 10, 20 and even 30 years later. There are a lot of options, And medicine is coming out with new treatments pretty regularly.
Hopefully Nubeqa won’t cause any problems, it is much easier on the system than Erleada. I’ve been on it for 2 years now And after 15 years of prostate cancer and four reoccurrences, it has kept me undetectable for the last 22 months. I’ve noticed no side effects from it and I know a lot of other people on it, many of them in their 80s, and it works very well for almost everyone.
After the pet scan, they may decide to do salvage radiation, or they may decide that there are noticeable metastasis that they can zap with SBRT radiation. Doctors at recent conferences have said that they just wait for people new tumors to show up and zap them, and that lasts for a long time.
You are definitely at the right place. You didn’t mention the PSMA PET scan earlier, but it’s great to hear they’re doing it.
You really have to wait to see what they find with the pet scan.
One thing you didn’t mention is his Gleason score. That is a critical piece of information that tells us more about what treatments will work and how long they will work.
While it does sound like the rising PSA is a major problem. You have to realize that treatment these days can handle what you are seeing quite easily. This isn’t time to panic. There are so many treatments and you are just beginning what could be a very long progression Free survival. I know many people that have had very serious cases Of prostate cancer and are still around 10, 20 and even 30 years later. There are a lot of options, And medicine is coming out with new treatments pretty regularly.
Hopefully Nubeqa won’t cause any problems, it is much easier on the system than Erleada. I’ve been on it for 2 years now And after 15 years of prostate cancer and four reoccurrences, it has kept me undetectable for the last 22 months. I’ve noticed no side effects from it and I know a lot of other people on it, many of them in their 80s, and it works very well for almost everyone.
After the pet scan, they may decide to do salvage radiation, or they may decide that there are noticeable metastasis that they can zap with SBRT radiation. Doctors at recent conferences have said that they just wait for people new tumors to show up and zap them, and that lasts for a long time.
Yes we chose UCLA after researching the best places on the west coast. Our doctors all seem to be on board with the latest treatments and they are all involved in clinical trials, teaching, etc. Everything changed when we were passed along to UCLA from our local urologist.
We know it’s aggressive and so do they. Gleason 9 with cribiform. That is one reason we chose to have surgery first and follow with radiation etc. I have a suspicion they waited on starting ADT because they wanted a better chance of seeing things on the PSMA PET. But obviously at this point they are saying starting the ADT will be beneficial. And they have mentioned just radiating individual spots as they show up.
ADT also has a role in sensitizing the prostate for direct radiotherapy.
With a negative PSMA PET CT scan for evidence of spread outside of the gland I have read that the chance of 5 years free from metastasis in G9 is 70%, and G8/80%. The PSA is monitored and if it goes up at 0.4 there is a 40% chance of finding metastasis. Typically in that case 60% of the time there is only one lymph node lesion affected on the new PSMA PET CT scan. In 20% of the time there are two lymph node lesions. They are treated with spot radiation. Once neutralized you would be back to square one. I suggest going to the PCRI.org You-Tube videos with Mark SCHOLZ MD He has ones on Gleason 8 and also Gleason 9.
Incidentally, the original Gleason percentages were derived from pre PSMA PET CT scan days and may now actually be more sanguine downward on the 5 yr mets free scale??
ADT also has a role in sensitizing the prostate for direct radiotherapy.
With a negative PSMA PET CT scan for evidence of spread outside of the gland I have read that the chance of 5 years free from metastasis in G9 is 70%, and G8/80%. The PSA is monitored and if it goes up at 0.4 there is a 40% chance of finding metastasis. Typically in that case 60% of the time there is only one lymph node lesion affected on the new PSMA PET CT scan. In 20% of the time there are two lymph node lesions. They are treated with spot radiation. Once neutralized you would be back to square one. I suggest going to the PCRI.org You-Tube videos with Mark SCHOLZ MD He has ones on Gleason 8 and also Gleason 9.
Incidentally, the original Gleason percentages were derived from pre PSMA PET CT scan days and may now actually be more sanguine downward on the 5 yr mets free scale??
Yes everyone especially the doctors are always saying that the PSMA pet has revolutionized prostate cancer care. My husband’s uncle got an aggressive type diagnosis in the 1980s and passed away less than a year later. I can’t imagine that happening now. Gives one a lot of hope which is important medicine! Thanks for your input.
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PSA was 6.3 when he recently started Orgovyx. Before surgery in June PSA was 10. Six weeks after surgery PSA was 1.9. Rose to 4.7 at 12 week check. Last week it was 6.3 and he started on the Orgovyx 3 days ago.
This is unfortunate. Before going on Orgovyx was a PSMA PET scan done? You want to do it when the PSA is high (above .7). Orgovyx Can take it down to undetectable and then you can’t see where metathesis are.
It would seem that salvage radiation would be one of the first things they would do, But it may be too late for that as high as the PSA has risen.
Hopefully you do not have just a urologist treating him. It definitely would seem like you should get a second opinion from a center of excellence. Something’s going wrong and you need to have aggressive treatment, But you need to see a group of doctors that can figure out what’s going on.
I have been on ORGOVYX 2 months- went from PSA of over 50 to PSA of .05 in 6 weeks or so..doc wants me to start Nubeqa now since I could not tolerate Erleada ( 9 dyas and quit it) ...so I am wondering if stopping ADT in 9 mos.might be as effective as 1 -2 yr...and if Cancer returns, maybe it will still be responsive to ADT therapy
The current protocol is throw everyhting at aggressive prostate cancer early on ( ADT for 12-24 mos + radiation) and hope for long period of remission/"cure"
Lots of guys on here who have been in this war for 5-10 yrs and know alot more than me..I can imagine a recurrence is pretty shattering...like being parolled for many yrs, then returened to prison.
He had PSMA before surgery and two lymph nodes lit up so we knew about those and the surgeon removed those and also found another cancerous node in the bilateral dissection. We finally got the insurance company to cover a new PSMA PET and that is scheduled to happen in a little over a week. In the meanwhile he just began the Orgovyx. Also has been referred to a radiologist. We are under the care of UCLA Urology Oncology and they are great. Oncologist said start the Orgovyx now to stop any activity and we’ll get a more specific treatment plan after the PSMA PET. He referred to radiology to get things going. I’m sick with worry.
Also thank you for your response.
You are definitely at the right place. You didn’t mention the PSMA PET scan earlier, but it’s great to hear they’re doing it.
You really have to wait to see what they find with the pet scan.
One thing you didn’t mention is his Gleason score. That is a critical piece of information that tells us more about what treatments will work and how long they will work.
While it does sound like the rising PSA is a major problem. You have to realize that treatment these days can handle what you are seeing quite easily. This isn’t time to panic. There are so many treatments and you are just beginning what could be a very long progression Free survival. I know many people that have had very serious cases Of prostate cancer and are still around 10, 20 and even 30 years later. There are a lot of options, And medicine is coming out with new treatments pretty regularly.
Hopefully Nubeqa won’t cause any problems, it is much easier on the system than Erleada. I’ve been on it for 2 years now And after 15 years of prostate cancer and four reoccurrences, it has kept me undetectable for the last 22 months. I’ve noticed no side effects from it and I know a lot of other people on it, many of them in their 80s, and it works very well for almost everyone.
After the pet scan, they may decide to do salvage radiation, or they may decide that there are noticeable metastasis that they can zap with SBRT radiation. Doctors at recent conferences have said that they just wait for people new tumors to show up and zap them, and that lasts for a long time.
-
Like -
Helpful -
Hug
2 ReactionsYes we chose UCLA after researching the best places on the west coast. Our doctors all seem to be on board with the latest treatments and they are all involved in clinical trials, teaching, etc. Everything changed when we were passed along to UCLA from our local urologist.
We know it’s aggressive and so do they. Gleason 9 with cribiform. That is one reason we chose to have surgery first and follow with radiation etc. I have a suspicion they waited on starting ADT because they wanted a better chance of seeing things on the PSMA PET. But obviously at this point they are saying starting the ADT will be beneficial. And they have mentioned just radiating individual spots as they show up.
-
Like -
Helpful -
Hug
1 ReactionADT also has a role in sensitizing the prostate for direct radiotherapy.
With a negative PSMA PET CT scan for evidence of spread outside of the gland I have read that the chance of 5 years free from metastasis in G9 is 70%, and G8/80%. The PSA is monitored and if it goes up at 0.4 there is a 40% chance of finding metastasis. Typically in that case 60% of the time there is only one lymph node lesion affected on the new PSMA PET CT scan. In 20% of the time there are two lymph node lesions. They are treated with spot radiation. Once neutralized you would be back to square one. I suggest going to the PCRI.org You-Tube videos with Mark SCHOLZ MD He has ones on Gleason 8 and also Gleason 9.
Incidentally, the original Gleason percentages were derived from pre PSMA PET CT scan days and may now actually be more sanguine downward on the 5 yr mets free scale??
-
Like -
Helpful -
Hug
2 ReactionsYes everyone especially the doctors are always saying that the PSMA pet has revolutionized prostate cancer care. My husband’s uncle got an aggressive type diagnosis in the 1980s and passed away less than a year later. I can’t imagine that happening now. Gives one a lot of hope which is important medicine! Thanks for your input.