After failed radiation and Lupron what comes next?

Posted by seabiscuit @seabiscuit, Dec 29, 2021

I am on Lupron now and would like to know what other choices i have. Radiation failed 6 years ago. And my choices seem limited. Just looking for input.

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Your information is too vague. Your choices would be based upon where your cancer is at now and your overall health condition. You could possibly be a candidate for surgery for prostate removal or more radiation based on that information. I had failed surgery then radiation then radiation again all with Lupron simultaneously.

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Without some clinical history, difficult to offer thoughts on the way ahead for you. It may help to put together a chart which shows your clinical history in a "picture" for both your medical team and online forums where you seek input from others who travel this road. Here's the one I use.

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I will give you a quik synopsis. 2013 i found Out I had prostate cancer. I had just come off Testosterone shots and had a Psa of 10. They did a Biopsy gleason score of 6 with 4 out of 12 needles showing cancer. They said i had time to choose a coarse of action. I choose radiation. I had 45 treatment stating in May of 2014. For 5 years Psa went up and down however it never got below 1.25. Two years ago I noticed it trending upwards. I contacted my Urologist he said we would keep an eye on it. It needed to double. One year after that it got up to Psa of 4. I got a petscan with Auxumin in August of 2020. The images were a little shady but it seemed to show cancer in prostate and Inglinal nodes. I was told that the cancer had metastasized. I went to clinic in Tampa. I live in Tallahassee. At this time covid was in full swing -motels and hotels were closed. So it was bacically a 14 hour wasted trip. I go there with latest and greatest petscan. They couldnt read the XRAY. This is a major cancer center. They wanted to do their own test and i had to come back. This trip was very long and uncomfortable for me. So i looked around. I had telephone conversation with a cancer clic in Birmingham. Sent them xrays with the report and all my files from my urologist and my cancer clinic in Tallahasee. This clinic specializes in Cryotherapy. Plus it was only 1 hour drive from brother in Montgomery Alabama. He said I could stay long as i needed. So last December 1 I went to clinic for biopsy and cryo. The doctor did biopsy and didnt find any cancer. Spent night at brothers because biopsies are painful without pain meds. Came back home. Three months later did another Psa test. I was now at 5. Still dealing with Covid. Clinic closure and getting scheduled. So my Urologist had me do a bone scan and body scan. No cancer anywhere. However now Psa at 6. He set me up with an Oncologist here in Tallahassee. He wanted to do his own scan at his office. I had to wait until August cause insurance Only paid for one a yeart and this scan is very expensive ( Petscan with Auxumin). It shows in prostate but not in nodes. He gives me speech about cancer having metastasized due to radiation failure even though it appears its still in the prostate. So Oct1 2021, I get my first Lupron shot. Due for another one in Jan. Hope that helps. I am just looking for other options. Seems to me my cancer is localized. Since Lupron does not stop the disease just looking ahead. Until now I was told by my urologist that more radiation was not a good idea and prostate removal after radiation was more difficult. Thats why I am here looking for answers. By the way I am 67.

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@kujhawk1978

Without some clinical history, difficult to offer thoughts on the way ahead for you. It may help to put together a chart which shows your clinical history in a "picture" for both your medical team and online forums where you seek input from others who travel this road. Here's the one I use.

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Wow, that's one detailed tracking system you came up with. Thanks for sharing.

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@dandl48

Wow, that's one detailed tracking system you came up with. Thanks for sharing.

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Whenever I am meeting with a new member of my medical team and they ask about my clinical history, this makes it easy to explain!

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no problem – i am just interested in discussion- Saw a few other new treatments that i wondered if anyone else considered. I saw an article where they are now able to deliver the chemotherapy medicine straight to the cancer. Anyone have more info on that. Also saw where they can make antibodies to fight your cancer however its very expensive. Anyone have any info on that

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@seabiscuit

I will give you a quik synopsis. 2013 i found Out I had prostate cancer. I had just come off Testosterone shots and had a Psa of 10. They did a Biopsy gleason score of 6 with 4 out of 12 needles showing cancer. They said i had time to choose a coarse of action. I choose radiation. I had 45 treatment stating in May of 2014. For 5 years Psa went up and down however it never got below 1.25. Two years ago I noticed it trending upwards. I contacted my Urologist he said we would keep an eye on it. It needed to double. One year after that it got up to Psa of 4. I got a petscan with Auxumin in August of 2020. The images were a little shady but it seemed to show cancer in prostate and Inglinal nodes. I was told that the cancer had metastasized. I went to clinic in Tampa. I live in Tallahassee. At this time covid was in full swing -motels and hotels were closed. So it was bacically a 14 hour wasted trip. I go there with latest and greatest petscan. They couldnt read the XRAY. This is a major cancer center. They wanted to do their own test and i had to come back. This trip was very long and uncomfortable for me. So i looked around. I had telephone conversation with a cancer clic in Birmingham. Sent them xrays with the report and all my files from my urologist and my cancer clinic in Tallahasee. This clinic specializes in Cryotherapy. Plus it was only 1 hour drive from brother in Montgomery Alabama. He said I could stay long as i needed. So last December 1 I went to clinic for biopsy and cryo. The doctor did biopsy and didnt find any cancer. Spent night at brothers because biopsies are painful without pain meds. Came back home. Three months later did another Psa test. I was now at 5. Still dealing with Covid. Clinic closure and getting scheduled. So my Urologist had me do a bone scan and body scan. No cancer anywhere. However now Psa at 6. He set me up with an Oncologist here in Tallahassee. He wanted to do his own scan at his office. I had to wait until August cause insurance Only paid for one a yeart and this scan is very expensive ( Petscan with Auxumin). It shows in prostate but not in nodes. He gives me speech about cancer having metastasized due to radiation failure even though it appears its still in the prostate. So Oct1 2021, I get my first Lupron shot. Due for another one in Jan. Hope that helps. I am just looking for other options. Seems to me my cancer is localized. Since Lupron does not stop the disease just looking ahead. Until now I was told by my urologist that more radiation was not a good idea and prostate removal after radiation was more difficult. Thats why I am here looking for answers. By the way I am 67.

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Hi, Prostate removal after radiation can be done very successfully. My father had it 12 years ago and he is now 90. He had original radiation at the age of 68 so this has been a long history. His surgeon was at Mayo in AZ and did an excellent job. Difficult, yes, impossible, no. I would suggest you see an expert at a 'center of excellence', Best wishes.

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Friend of mine had it done 2 years ago -he still wearing a diaper. That will be my last chioice. But thanks for input.

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Just wondering if someone has had the lastest scan with Gallium PSMA I believe it is called. I am still thinking cryo or ultrasound if they can get good picture of it. I think the cancer is still localized to prostate.

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I have an appt next week with doctor and will discuss other options over Lupron.

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@seabiscuit

I have an appt next week with doctor and will discuss other options over Lupron.

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Scans while on Lupron are not very effective. It shrinks the cancer making it almost impossible to find even with the better scans. You need the scans while off Lupron and you need the C11Choline or PSMA scans which are much more precise. That’s why I switched my care to Mayo who were able to find my cancer that the other scans missed. I suggest going to a specialist who deals with salvage radical prostatectomies. Don’t panic,if the Lupron is working as it usually does on most people it buys you time.

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My husband was diagnoised with metastatic prostate cancer in December 2020. The following month, he had an appointment at Mayo Clinic for a second opinion. The C11- choline PET scan confirmed the diagnosis. Mayo gave him a shot of Firmagon. In February 2021, he started his six chemo treatments every three weeks. In between all of this & still to this day, he gets a shot of Lupron every three months. When I asked the doctor about his prognosis, I was told things are at bay. This past summer, he was diagnosised with a pulmonay embolism. In both lungs. He now takes Eliquis twice a day. All of this is buying him more time. It's hard, for me, being his caretaker. He's a narcissist. And a narcissist with cancer is even worse!

I recommend going to Mayo Clinic for any serious illiness/second opinion. Thanks to them, I'm a 29 year brain tumor survivor!!

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