Opinion wanted on PSA result

Good question about the PET Scan. If the reason he had the orchiectomy was prostate cancer vs testicular cancer, I wonder why his urologist did not do the PET Scan pre-surgically? If it was prostate cancer, the urologist would want to know if the cancer was "prostate confined", or if in fact it was spreading to lymph nodes and/or bones. You unfortunately don't know, and for some reason radiation was done instead of prostatectomy...again, assuming he has prostate cancer (seems he does). If he did have prostate cancer, "why" did he go for radiation "first", when that is customarily done "after" radical prostatectomy if/when there are new, detectable and increasing PSA levels. Radiation "first" just made it much ore difficult to surgically remove the prostate if needed, now that it is scarred and is like a chunk of concrete. Please offer some answers and more clarity on what is going on with him. Good luck to you and him.

@sbd

A reduction and testosterone caused by the following drugs, cause the below problems.

Due to their different mechanisms of action. ADT which includes Orgovyx, Firmagon, Lupron, Eligard, Prostap, Camcevi, Lucrin, Zoladex, Trelstar, Pamorelin, and Decapeptyl can cause numerous side effects. Actually due to a lack of testosterone.
Hot flashes
Fatigue
Muscle deterioration
Bone weakening
Brain fog
Depression
Weight gain
Joint pain
Difficulty in breathing

Not all of these side effects occur to everyone on the drugs. Most of them are just things you have to be aware of and circumvent. I run on the track twice a day, 1 mile at least, to help prevent bone weakening, fatigue and muscle deterioration. I also go to the gym three days a week (usually) and spend an hour with all different types of weight exercises. One thing that happens is people get a beer belly from the muscle deterioration, I do a lot of sit-ups to offset that.

Some people get depression but it is not common. It is easily treatable, according to people that have reported it on here and on Online Meetings I have participated in. If he has that problem Come back and ask for help, Or see a psychiatrist about doing something to relieve the depression.

Some people get no hot flashes at all. Others only have a few hot flashes and they are very minor. I had severe hot flashes for the first year on Lupron. As a hot flash was hitting I would feel a lot of fatigue. After a year, my oncologist prescribed a depo-provera shot every three months and it really stopped those hot flashes on Lupron. There are other hormones that can do this, speak to your doctor. If you have this problem, we can give you a list of drugs that can stop it. Ae doctor at a recent conference, put out a big list
I know one person that says eating tofu every day really controlled his hot flashes, another person in this forum said the same thing. Tofu does have properties similar to endocrine hormones but a lot weaker. Can’t hurt to try it. Seems they ate it daily.

According to a doctor that spoke to a recent webinar, many people on ADT, if they are staying on ADT for an extended period or have become castrate resistant should be taking bone straighteners. I took Fosamax for six years and I’m now on Zometa. That along with calcium taken daily helps keep your bones strong. Ask your doctor about this.

I have never gained any weight while on ADT. I get on the scale every morning and base what I eat on what I weigh. Skip lunch at times. Some people gain a lot of weight. The average is 5 pounds but some gain more and some gain none..

If there was a lot of fatigue, exercising actually can offset it. It sounds kinda productive, but actually getting out there and walking bike riding, weight training, isometric exercise exercises whatever you want to do to exercise can help reduce the fatigue you feel.

Good question about the PET Scan. If the reason he had the orchiectomy was prostate cancer vs testicular cancer, I wonder why his urologist did not do the PET Scan pre-surgically? If it was prostate cancer, the urologist would want to know if the cancer was "prostate confined", or if in fact it was spreading to lymph nodes and/or bones. You unfortunately don't know, and for some reason radiation was done instead of prostatectomy...again, assuming he has prostate cancer (seems he does). If he did have prostate cancer, "why" did he go for radiation "first", when that is customarily done "after" radical prostatectomy if/when there are new, detectable and increasing PSA levels. Radiation "first" just made it much ore difficult to surgically remove the prostate if needed, now that it is scarred and is like a chunk of concrete. Please offer some answers and more clarity on what is going on with him. Good luck to you and him.

@jeffmarc Thanks a lot Jeff, he has been following your guidance for the past few months. Walks daily atleast 4-5 times a week and also goes to the gym and uses machines and light weights. One question, apart from exercise, are there other ways to improve the fatigue? Otherwise, he is doing alright, and has a decent set routine.

After orchiectomy, now he is on Abiraterone+P. Fatigue isn't that bad, and manageable with exercises. But there are days when he doesn't want to do much and just rest..(which could also age related and nothing to do with PCa)..

@sbd
Abiraterone can cause serious fatigue. Increasing prednisone to 7.5mg can make a big difference. The standard dose of prednisone is either five or 10 mg with Zytiga.

If there was just a little bit of fatigue than 7 1/2 would probably do. I was working with a guy who would wake up and have to go back to sleep for three hours because Zytiga was just exhausting him. He moved up to 10 mg and it helped a lot.

At one of the conferences, I went to a Doctor discussed his prostate cancer problems, he had a lot of fatigue so he moved up to 7 1/2 mg of prednisone And was happy with that. Unfortunately, it raised his blood sugar so he had to drop back down. Something to be aware of.

I know some people that have had their standard dose set to 10 mg when they were given prednisone with Abbie. Just depends on what the doctor likes to do.

Something to discuss with your doctor.

Try not to let PSA define you and your cancer. It's hard to do. For me my PSA never been normal, never good. 6.3 Years in on this advanced prostate journey and my PSA always high, causing another exam, another test, another appointment. Last year my oncology and I went heart to heart and I asked him for a break from PSA Lab and his response surprised me. He said "You deserve one, it will help your quality of life." He's right, and the PSA break helped my QOL.