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

Yes.

If somebody is on ADT within 2 to 3 years, they are most likely to find that the drug no longer keeps their PSA down. At that point, they are castrate resistant and need the second drug an ARSI.

I became castrate resistant 2 1/2 years after I started Lupron, almost exactly 6 years ago. Talk about textbook case, dead in the middle of the normal time.

I have remained undetectable for the last 20 months after 15 years of PC.

I had one shot of Lupron on November 11, 2024. My PSA dropped from 16.5 to 1.2 in 3 days. Since then my PSA has been undetectable. I cancelled further treatment; no abiraterone; no more Lupron(scheduled for 4xper year) no radiation. Hate the Lupron side effects ----- sweats; inner tub belly; muscle softening; stamina loss. The side effects are lessening very slowly . I had a buddy who had radiation and hormone treatment and felt so bad that he started taking testastorne shots.
I considered myself a bad patient for radiation because of my age (84) and weak bladder.
I think I was just lucky. As far as I can determine there are a lot of treatments; and they work differently on different people. Also the state of the art in radiation seems to be progressing rapidly - I had a friend who took radiation 5 times a week for 8 weeks in 2023; I was scheduled for 5 radiation treatments a week for 5 weeks; another friend is scheduled next month for 5 treatments in 5 days ! Get all the information you can; If you know any MD's who have or had Prostate Cancer talk to them; I found a couple and they were very helpful.
Hang in there - you have a lot of company and this J-H site is the best.
spyglass 566

What they likely said was that they hope for a PSA of “undetectable.”

Probably so…

Don’t know what Zytiga is?
Besides the Lupron shot, all I take is that Abiraterone pills. That says “ Take 4 tablets by mouth daily for P cancer on empty stomach 250mg. The pharmacy told me not to eat for 4 hours which made me think of taking them at my first pee calling around 1 am.
The prednisone 5mg says “ take 1 pill a day The nurse in oncology told me to take it with food; presenting the conflict with the meds I now take at 1am The only other meds I take are Crestor when I go to bed, and Nuvigil around 7 am and 10 mg of
Oxycodone 4 times a day RXd for disc pain and arthritis pain.
Every so often I take 600 mg of Ibuprofen.
Not one other prostate cancer medication.
I want to ask the oncology pharmacist to RX one? Or more of the calcium pills you mentioned elsewhere. I do take Calcium citrate from Nature Made in a very pleasant liquid form which I mix 2 tablespoons into lemon aid.
I think it would help me greatly if there existed a list of all the meds mention in these forums along with what they’re RX’d for.
It seems abvious to me that I know a lot less about my cancer than most of the forum visitors know.
As mentioned: never once since I was first DX’d has anyone mentioned “ a stage “
Is stage related to Gleason score?
Thanks

Given the heterogeneity of PCa, determining and average "drop" in PSA when initiating ADT may be a challenge.

I have seen various studies that point to a rapid decline in PSA to undetectable within the first six months is an indicator of "longer PFS and RPFS" "remissions."

As I recall from the EMBARK trial, those who achieved "undetectability" at that point were "allowed" to come off treatment..
Patients whose PSA levels reached undetectable levels (< 0.2 ng per milliliter) at week 36 had their treatment suspended (Fig. S5). In the combination group, 90.9% of the patients (321 of 353 patients) had treatment suspended for a median of 20.2 months (range, 5.7 to 87.9); 43.9% of these patients did not receive treatment for more than 24 months. A total of 67.8% of the patients (240 of 354 patients) in the leuprolide-alone group had treatment suspended (median, 16.8 months [range, 3.4 to 83.0]); 32.1% did not receive treatment for more than 24 months. In the monotherapy group, 85.9% of the patients (304 of 354 patients) had treatment suspended for a median of 11.1 months (range, 2.3 to 84.9); 20.4% did not receive treatment for 24 months...
https://www.nejm.org/doi/full/10.1056/NEJMoa2303974
I have not tracked the rate of PSA drop when initiating ADT in part, because my PSA has never climbed above 5 vice those in the high double, triple or quadruple digits.

As to your medical team and their dearth of information, well, if you are in the position to do so, firing them is an option. If not, you are going to have to take greater responsibility, advocate for yourself, learn the terms, definitions, read up on the guidelines from organizations such as NCCN and AUA, There are organizations with valuable resources, PCRI and PCF are two, you can find others.
https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459
https://www.auanet.org/guidelines-and-quality/guidelines/oncology-guidelines/prostate-cancer
https://pcri.org/
https://www.pcf.org/
Kevin

I, too, have a family doctor that thankfully continued with PSA testing in recent years, revealed an elevated level, and sent me on to prostate treatment. I never had any symptoms but revealed Grade 5 Gleason, ended up with a RALP and intermittent ADT for last 2 plus years. At 74 I'm not what I used to be, but much better than I would have been. I would never have considered her to be old fashioned, but she likely has saved my life.