PSA - 17.1, are Lupron injections necessary?

I am 76 and was on lupron and Erleada for a year ( 2 drugs that are often given together now) and the side effects were not bad. In my opinion, 79 in and of itself is not too old to get treatment as your grandfather might have 5-10 or more years of quality life. Also, taking these meds is not irreversible and if he has a terrible reaction he can stop it. Good luck

I would look at the Orgovix or a low dose Lupron shot. Nothing more than 22.5mg(3 month shot) maybe less then that then if he doesn’t tolerate it,it will where off quicker.

I faced some of this thinking and I am 10 yrs younger.
Lupron made me weak and I am still walking with instability which I partly blame on Lupron. However,
it’s an effective part of the process of getting rid of the prostate cancer. I think of this like a mechanic going to
rebuild an engine without a full set of wrenches. Lupron starves the cancer…a good thing because without its testosterone food cancer should not grow.
A PSA score of 17 is about 2 times the level I started on hormone therapy before getting brachytherapy.
I have had all the treatments now and my PSA is 0.022.
Would I elect what I did again? You bet!

Q: what Drs and Specialties are recommending ADT? And why?
In 2000, my father was 80 with no medical problems. His PSA was tested (for no reason known to me) and was 11. He had a 12 core biopsy that had 1 hit (Gleason score not known). He chose "watchful waiting", and I never heard about prostate cancer again. He passed at almost 95 from "old age".
There are many questions about my Dad's situation that I have in retrospect, since my high risk Gleason 9 cancer was identified in 2022.
So my post may be "uninformed ".

Is his only "symptom" an elevated PSA. Why was a PSA performed on a healthy 79 yr old? Has it been repeated? Has a biopsy been considered and performed, and was any cancer found and what was the Gleason score? Again, who is treating him and is ADT the Dr's recommendation, and why?

FYI: I have had RP and am undergoing salvage radiation and hormone therapy presently, and generally believe in treatment.

Treatment for a low risk Prostate cancer, Gleason score 6 or 7 or less, is usually to monitor and test, that is much different than treatment for an aggressive high Gleason score cancer. You and I both have an aggressive Gleason score 9 cancer. I had a year of ADT plus Erleada and RP. It appears that my cancer is presently sleeping and I will do all that my doctors tell me to do to keep my cancer sleeping. I think that getting aggressive treatment for my aggressive cancer was the right thing to do and I am thankful that I got it and hopeful for the long future.

Yuliyalt:

To expand a bit; one does not treat elevated PSA. You treat prostate cancer. And sometimes not.

Does your Grandfather have an actual cancer diagnosis, and if so, what is the Gleason grade.

Falling is a significant risk on hormone therapy, and particularly for elders.

Other posts have noted instability. A close friend on hormone therapy had "dizziness", tripped, fell, hit his head and required surgery to relieve hematoma pressure on his brain.

I have at times, especially the first couple of weeks, felt "wozziness" or "off".
So I think falling is a real side effect.

Most importantly, what is/are his dr(s) saying?

My grandfather is 79, his PSA level is 17.1, he is NOT on any treatment currently. He is generally healthy and is not taking ANY medication.

To best help this group, may be useful as others have said to add any clinical data on his diagnosis.

Has he had a biopsy, if so, what are the results?
Has he had any imaging, if so...?
Has he had any prior PSA tests, if so...?

You say generally healthy, the MSKCC has a life expectancy calculator - https://www.mskcc.org/nomograms/prostate

These pieces of clinical data can inform any treatment decision. For example, the Gleason Score, PSA doubling and velocity times, whether the prostate cancer is confined to the prostate or has spread outside it and where.

Generally healthy, does he have any cardiovascular issue, weight and BMI, diabetes...

Depending on the clinical data, this group can better respond.

As to the side affects of Lupron, well that can vary, depending on various things. If you've had any statistics training, think Bell Curve, most men will fall inside the Bell Curve in terms of side affects, hot flashes, fatigue, muscle and joint stiffness, cardio vascular and metabolic, genital shrinkage, loss of libido... Some will experience fairly severe side affects, others very mild. There are mitigating strategies, particularly diet and exercise.

There are some studies which may lead to a conclusion that it may be 8-10 years before your father shows any evidence of metastasis, so, no reason to treat until they do. That does not mean come back in 8-10 years, rather, he must actively monitor though labs and consults during that time.

Kevin

More importantly, is he being currently followed by a urologist or oncologist and if so, has he been diagnosed with prostate cancer? He really needs to have some sort of treatment plan in place.

You don't say if your grandfather is going to do any treatment at all or how long he says he wants to live. Has he had an MRI or just a high PSA. Studies have shown that depending upon the severity of the cancer that for men over 70 Androgen Deprivation Therapy makes no difference in biochemical reoccurrence or mastastis from the prostate. Not enough information in your question to give a logical answer based on actual studies and data.

Is he on.Flomax I read article that said, if you’re on Flomax, you could possibly have a high PSA test because of it. Just thought I’d throw that out there. Good luck Dave