1. < Prostate Cancer

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?

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spino | @spino | Nov 16, 2023
In reply to @kujhawk1978 "It may help this group yo provide more clinical data which might include clinical history, did..." + (show)
@kujhawk1978

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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Kevin, that chart is incredible. Of course, I hope I never have one with so much on it.... I think BCR (biochemical recurrence) is by definition based on PSA, right? The imaging then tries to figure out the why behind it.
From your chart, it looks like I could call that two BCR's, which you have marked with the red graph lines.
I spent some time studying your chart just now, and my biggest reaction is just one from the heart--this has been a challenging and frustrating journey, but you are still alive and taking action with your medical team. My secondary reaction is to soberly brace myself, because there may be much more to my own PC journey than I have yet experienced.

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kujhawk1978 | @kujhawk1978 | Nov 16, 2023
In reply to @spino "Kevin, that chart is incredible. Of course, I hope I never have one with so much..." + (show)
@spino

Kevin, that chart is incredible. Of course, I hope I never have one with so much on it.... I think BCR (biochemical recurrence) is by definition based on PSA, right? The imaging then tries to figure out the why behind it.
From your chart, it looks like I could call that two BCR's, which you have marked with the red graph lines.
I spent some time studying your chart just now, and my biggest reaction is just one from the heart--this has been a challenging and frustrating journey, but you are still alive and taking action with your medical team. My secondary reaction is to soberly brace myself, because there may be much more to my own PC journey than I have yet experienced.

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Yeah, coming up on the 10 year mark. During that time I have seen both daughters graduate from college and establish themselves in their lives, celebrated 10 Christmas, Thanksgivings, anniversaries....taken vacations to Iceland, Colorado, Oregon, the Big 5 in Utah, Grand Canyon, elsewhere...you get the idea, lots of living!

I am fortunate, 27k or so die each year, my treatment has so far meant I am not one of them. Roughly three years on treatment, seven off.

I have chosen to be aggressive faced with a pesky and aggressive cancer. I have also taken an approach which says actively monitor off treatment, go back on treatment early and then for a definitive time, coming off based on clinical data my medical team and I agree to.

You are correct, BCR is generally defined by a detectable and rising PSA, what that level is depends on whether you had radiation, surgery, using an ultra sensitive PSA test or standard one.

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itterac | @itterac | Nov 16, 2023

Thanks. As always I appreciate ur valuable input. I hope to do the same.

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itterac | @itterac | Nov 16, 2023
In reply to @michaelcharles "Guys are just trying to be responsive, so please be nice(r). We are all in, or..." + (show)
@michaelcharles

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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Thanks for ur story. I’m usually always nice except when insulted.

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gently | @gently | Nov 16, 2023
In reply to @michaelcharles "Guys are just trying to be responsive, so please be nice(r). We are all in, or..." + (show)
@michaelcharles

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.

Jump to this post

nice(r) I'm savoring that expression.

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