Treatment after rp radiation and 2 bcrs

Posted by itterac @itterac, Nov 14, 2023

Psa .24 December- .51 in august. Psma pet in April negative. Urologist prescribed bicultamide and finestride. Anyone do this combo or either one. Should I b doing anything else. This about my third post on this. No one ever responds. Colleen thoughts?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I'm so new to this, but you have to have at least one answer, even if it's no good.
https://ishrs.org/finasteride-and-prostate-cancer/#:~:text=Finasteride%205%20mg%20(Proscar%C2%AE),-Although%20the%20investigators&text=The%20study%20showed%20that%20Proscar,developing%20high%2Dmalignancy%20prostate%20cancer.

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I wonder how precise the measurement is. I was concerned about a different (secondary) blood test, but my onco team assured me it was likely just normal fluctuation, not a trend, and indeed it did come back down to normal in my next blood test and the ones after.

From what I understand, for people not under treatment a PSA at or below 2.5 ng/ml is considered "normal" for men in their 40s and 50s, and anything at or below 4.0 ng/ml is "normal" for men in their 60s. Obviously, they're aiming for lower with ADT, but still, maybe you're not seeing the start of a trend, but just a wobble (?)

As always, layperson talking here. In any case, if you reach out, your onco team should make themselves available to discuss any test results you're concerned about and what they might mean.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines

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@gently

I'm so new to this, but you have to have at least one answer, even if it's no good.
https://ishrs.org/finasteride-and-prostate-cancer/#:~:text=Finasteride%205%20mg%20(Proscar%C2%AE),-Although%20the%20investigators&text=The%20study%20showed%20that%20Proscar,developing%20high%2Dmalignancy%20prostate%20cancer.

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Lol thanks

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It may help this group yo provide more clinical data which might include clinical history, did you have surgery or not, when, pathology report..,

When was your BCR, were they PSA based only or PSA and imaging?

What were the treatments for your previous BCRs?

With those PSA results it's generally not useful to use those for calculating PSADT.

There is nothing "wrong" with what you and your medical team are doing given the clinical data you provide.

Is this for a definitive time and what clinical data would determine coming off?

If this combination of drugs knocks your PSA to undetectable and keeps it there, well, you have your answer. If your PSA starts rising while on this treatment that's another discussion with your medical team and this forum.

Attached is a chart I use to track my clinical history for discussions with my medical team.

Kevin

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Thanks. I have provided my full clinical picture over 10 times. I usually don’t get any response so went w readers digest. Diagnosed unofficially 3/17. Officially 1/18- 7-4/3. Ecp. Rp 4/18. Bcr 12/20. 36 ebrt, w 90 d adt in mid 2021. Bcr 12/22. Finestride first then bicultamide after psa still rising. Next psa in 2 weeks. Thoughts?

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@northoftheborder

I wonder how precise the measurement is. I was concerned about a different (secondary) blood test, but my onco team assured me it was likely just normal fluctuation, not a trend, and indeed it did come back down to normal in my next blood test and the ones after.

From what I understand, for people not under treatment a PSA at or below 2.5 ng/ml is considered "normal" for men in their 40s and 50s, and anything at or below 4.0 ng/ml is "normal" for men in their 60s. Obviously, they're aiming for lower with ADT, but still, maybe you're not seeing the start of a trend, but just a wobble (?)

As always, layperson talking here. In any case, if you reach out, your onco team should make themselves available to discuss any test results you're concerned about and what they might mean.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines

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Thanks

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@itterac

Thanks. I have provided my full clinical picture over 10 times. I usually don’t get any response so went w readers digest. Diagnosed unofficially 3/17. Officially 1/18- 7-4/3. Ecp. Rp 4/18. Bcr 12/20. 36 ebrt, w 90 d adt in mid 2021. Bcr 12/22. Finestride first then bicultamide after psa still rising. Next psa in 2 weeks. Thoughts?

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I agree with kujihawk. The information you have provided is very difficult to follow and seems to be incomplete, as is the readers digest version. I have never heard of being diagnosed unofficially and then officially. What was your PSA when your first BCR occured? I am not aware of one having a 2nd BCR. It is often a fault of those posting to be too cryptic or too rambling.

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@gkm

I agree with kujihawk. The information you have provided is very difficult to follow and seems to be incomplete, as is the readers digest version. I have never heard of being diagnosed unofficially and then officially. What was your PSA when your first BCR occured? I am not aware of one having a 2nd BCR. It is often a fault of those posting to be too cryptic or too rambling.

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Unofficially means in 2017 my psa rose to 3.3. I had it then. Urologist didn’t think I had pc. Psa 6m later 4.5. January biopsy. Pc 7 4/3. Now u have heard of second bcr after rp and ebrt. First bcr .24. Second bcr .26 rising to .51. Nothing about my post was cryptic or rambling. Ur comment totally inappropriate and demonstrates a complete lack of knowledge about pc. Pls don’t respond to any of my posts.

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@itterac

Unofficially means in 2017 my psa rose to 3.3. I had it then. Urologist didn’t think I had pc. Psa 6m later 4.5. January biopsy. Pc 7 4/3. Now u have heard of second bcr after rp and ebrt. First bcr .24. Second bcr .26 rising to .51. Nothing about my post was cryptic or rambling. Ur comment totally inappropriate and demonstrates a complete lack of knowledge about pc. Pls don’t respond to any of my posts.

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Guys are just trying to be responsive, so please be nice(r). We are all in, or have had, treatment (tx) and I know that I misread or misinterpret posts from time to time. And it is the writer's responsibility to communicate clearly.
When tx fails; we look for additional tx.
I had RP, immediate detectable BCR @ PSA of .19; completed salvage radiation and ADT last June and actually am anxiously waiting for 1st post BCR tx uPSA results from blood test yesterday.
If, or when, I have detectable PSA, that would be a 2d BCR and I would seek additional tx.
There is a video from Jan 2023 on PCI.org that addresses rising PSA after RP or radiation, and you might find that helpful.
God luck.

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@itterac

Unofficially means in 2017 my psa rose to 3.3. I had it then. Urologist didn’t think I had pc. Psa 6m later 4.5. January biopsy. Pc 7 4/3. Now u have heard of second bcr after rp and ebrt. First bcr .24. Second bcr .26 rising to .51. Nothing about my post was cryptic or rambling. Ur comment totally inappropriate and demonstrates a complete lack of knowledge about pc. Pls don’t respond to any of my posts.

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PCF.org - pardon my error

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