Is there an average and/or an expected drop in PSA after Lupron shot?

"... unless you’re hit by a bus you can rest assured that you will die from this cancer." You were told this - really?

Honest! The doc who told me that said something similar about his own up and coming hip replacement surgery: “ if I’m not dead from my hip replacement surgery; I’ll see you in two weeks. Now post hip surgery he said the pain is so bad if I had a choice of this pain or dying; I’d choose dying “ I’m thinking that this might be his sense of humour.

Optimally, Lupron should lower your testosterone to below 50 ng/dL, which should starve/weaken the prostate cancers enough to lower your PSA to undetectable.

They have me scheduled for my next PSA test in 3 months (2 months remaining)
For the most part I’ve been feeling better, go to the bathroom less at night and less during the day as well But I’m most pleased with the strength of the stream: I can be heard peeing from the other room with bathroom door closed! A strange thing to be proud of!

Your PSA will probably be < .1 In 6 months, it won’t be far from that when you have it tested in two months, Could already be there. It does go down pretty quickly. It’ll stay there the whole time you’re on Lupron until you become castrate resistant. There is no rule to calculate how quickly it will go down.

Thanks for the reply Jeff. Getting older has been most difficult as I become either wiser or more judgmental; not understanding how and why I’m so unfamiliar with the in’s and outs of this cancer.
When I was told to report to the oncology clinic and showed up, one of the nurses met with me to explain why I was transferred to the clinic from regular urology appointments. She went on: “ you’re here because we want to know why your PSA has been going up AFTER A Prostatectomy. “ She reminds me of the history: 6 months ago your PSA was 60, then a few months ago it rose to 100, then a couple of months after that it hit 112” I interrupted her to first say: “ I still have my prostate” She immediately replied: “ No you don’t. It says right here in your records that you prostate is missing “ ( strange choice of words, it would have made more sense to me is she gave me a date that it was removed ) She dives back into the records perhaps looking for that information. But she misinterpreted, I later found out; words to the effect that my “ pelvic floor was empty “ or something akin to that which were the words of someone in the process who read the so called definitive test which I’ve seen it mentioned here; which involves a PET and CAT SCAN done at the same time. I had that test conducted twice 3 months apart.
The first time it was ordered by my Urologist, who called me the minute he got the results, which was before I returned home after the test ( about 90 minutes after the test. I really like my urologist who was sincerely concerned that I hadn’t done anything since the cancer dx and warmed me that with a PSA OF 100 I very likely had the cancer Metastasize into my bones or other likely places that this cancer goes if not treated in some approved way ( hormone therapy and or radiation ) My doctor excitedly said I’m calling you about the results of you test which presents both positive news and a mystery. “ The cancer has not spread but that it hasn’t spread with a PSA of 100 for many months now ‘WHY HASN'T IT SPREAD’ is the mystery” I think you should consider hormone therapy at the minimum and we’ll redo the test in a couple of months.
I agreed to his suggestion already after discussing the results of the test with the assigned oncologist in the oncology clinic. BTW I really like him as well mostly because he was a great listener and he was aware of my fear of Lupron based on watching my Dad after he started Lupron injections. He suggested starting with a one month dose. In fact he ordered it while I was still talking with him; he called up to the Urology clinic to administer the one month dose. Turned out that the pharmacy didn’t have one month doses but it took over an hour to tell me I had to return for the shot once it was in house. Turns out that the message to notify me when it arrived fell thru the cracks of VA HEALTH CARE. It took well over a month before I was notified that it had arrived but there wasn’t an appointment open with my doc for three months and I had to make numerous calls for the VA to realize that the doc didn’t need to administer the shot. It was close to three months before I drove the 150 miles to get the shot which a nurse administered to the fatty part of my arm. By then my PSA reached 112.
They scheduled a retest of the PET/CAT scan which I was told by the same oncologist who approved the one month dose. He said your retest is almost the same as your first test so I recommend starting radiation. I asked about the type of radiation that seems to target the cancer only.
Meanwhile someone in the chain of command saw things differently and said that it was now in my bones.
Almost 4 months have passed and I have mostly been told erroneous info; like I have no prostate.
Meanwhile after 3 one month doses of Lupron, my PSA went from 112 to 15 seemingly Delighting everyone who has seen the 97 point drop. But I was also told by the doc who said I can rest assured that “ this cancer will be the death of you “ that I am not a Candidate for radiation! That makes no sense to me since the first oncologist wanted to target the cancer in the prostate.
This brings me back to the furst news of cancer " the size of a dime " in my Prostate.
i dont know who to believe. I've been to two very well respected cancer, hospitals, and the VA each one has a different take on what I should do making me even more confused.
Sorry for the Length of this post.
I'd like to hear what the people here in the Mayo Clinic connect form have to say maybe I can get some better advice than what I've been getting from the so-called professionals
Thanks again for replying!

No idea if this applies to the OP's situation, but there are two old-fashioned views that are both tragically wrong (but unfortunately not entirely eradicated from some of the backwaters the medical community):

❌ Prostate cancer is always a slow-developing disease that you die *with* (in old age) rather than *of*.

❌ Advanced prostate cancer (esp. stage 4) is terminal, and all they can do is keep you comfortable with palliative treatments for your remaining years or months.

So first they tell you there's nothing to worry about, then when the cancer advances, they tell you there's nothing they can do. 🤦

The huge surge in de-novo stage-4 prostate cancer diagnoses in recent years (after the medical community officially abandoned routine PSA screening as "unnecessary") gives the lie to #1. And all the new treatments that have emerged in the past 5–10 years have made metastatic prostate cancer often into a chronic rather than terminal disease: one that you might actually be able to live with into old age with the right treatments (but still something it's much better to avoid than have to treat).

Fortunately, the word is spreading, and those old views are withering: in 2025 it's not just the "Centers of Excellence" that know about the seismic shifts in prostate-cancer treatment, as many have reported here. Just get thee to an oncologist or an oncologic urologist at good research/teaching hospital that's affiliated with a university medical school, and ask questions politely but relentlessly.

(Note: "old-fashioned" isn't always bad; many here in the forum have benefited from early detection through stubborn, old-fashioned family doctors who kept ordering routine annual PSA screening for all male patients over 50, even though the medical authorities in the U.S., Canada, Europe, and elsewhere had ruled it unnecessary.)

Jeff, hope feeling well, is castration resistant all part of the scenario if you will. In other words is it guaranteed to mutate to castration resistant?

@northofthebirder In the context of the last paragraph of your comment, my "old-fashioned" family doctor asked me last October if I would like her to order a PSA test. The test came back with 7.9; she then asked if I would like a referral to a urologist. She copied me the referral; asked me to do the follow ups. The urologist ordered another PSA testin late January, the result was almost 3 points higher @10+; the urologist did a biopsy in February -- Gleason 7 (4+3) in three of 14 cores, unfavorable intermediate. I started Orgovyx on March 26, SBRT on April 9-21. My PSA was 0.36 on July 9; my RO said to continue Orgovyx three more months, then I can stop; will monitor how my PS fluctuates up & down post-Orgovyx. I believe my old-fashioned family doctor did me a huge favor.

While ADT is initially effective in most cases of advanced prostate cancer, the majority of patients eventually develop castration-resistant prostate cancer (CRPC) within 2-3 years.

It took me 2.5 years to become CRPC. I did have to start Zytiga when it happened. It has made absolutely no difference in my continued good health. The drugs that weren’t here 20 years ago are allowing us to live with minimal issues. My father died of prostate cancer because those drugs weren’t available.