PSA levels

Hi Sits

Sorry to hear about your husband.

I think PSA 19 is OK, shows the HT working. PSA probably won't go down to the really low levels seen when going thru RT and surgery.

As has spread to the spine probably unlikely RT could cure it but if they think that it could then would go with it.

Once in the bones it does get a lot more difficult.

But people on  HT can survive for years and if the PSA starts rising again they can use an alternative one.

The question I would ask the specialist is what will the RT actually do , is a cure possible?

best wishes

Steve

Hello spirit and welcome!

Before I respond to your question I want to say that I am not a prostate cancer specialist and so will be typing only from the understanding I have gathered on this journey with my husband.

So, my understanding is that hormone therapy deprives the cancer cells of testosterone which they need in order to reproduce and  grow and spread -.it doesn't kill the cancer cells.

Radiotherapy does kill the cells but if the cancer has spread to other parts of the body, it is not usually offered. That said, if. There is, say, a lot of pain from secondaries in a bone then radiotherapy helps to control that pain.

Enzalutamide is a newer drug which has been shown to be effective as an addition to the older type of hormone therapy (or, I think, instead of if the older ht has stopped working?) in controlling the growth of the cancer.

It is important to remember that a higher PSA can be caused by things other than cancer such as a benign enlarged prostate,  infection etc

It is also important to note that there is a lot of research ongoing and new drugs and treatments are potentially coming down the track. Also, the doctors have an armoury of  treatments to offer ( ie chemotherapy) right now

what I can’t find an answer to, is, if the cancer cells are stopped from reproducing, does there come a point at which they die off and , if so, how long until that happens? This really puzzles me particularly because my husband has been told, at different points along this journey, that he will need hormone therapy for 2-3 years, then 6 months, then 18 months and lastly 12 months.

I am sure that some of the more knowledgeable contributors to this forum will correct any of my misunderstandings and offer you a more expert answer. 

I do, though, wish you and your husband well on this journey which I have experienced as particularly rocky at times.

Hi WW

My understanding about cancer cells and HT is that it does kill some of them and subdues the rest. that is why when HT stops PSA starts rising again, this is more with  advanced cancers not necessarily with treated cancers ie RT or surgery.

This is only my thinking and could of course be totally wrong

Best wishes

Steve

Hello SpiritintheSky

Welcome to the Prostate Caner forum - we are a decent bunch.

 Worriedwife and Grundo have both stolen my thunder with what I understand to be the correct answers. I can't understand thought why Chemo hasn't been offered with the spread to his spine.

I hope this helps and good luck with his journey.

Kind Regards

Brian.

Hello Steve, I have always acknowledged your vast knowledge and experience of prostate cancer and its treatment options. However, if I can’t find the answer to my question and you are uncertain about your own answer, does this mean the medical people are treating you men while being somewhat blindfolded? I asked the oncology consultant the same question and his reply was, ‘that’s the million dollar question’. I find it hard to believe that there is not an answer to be found, do you?

I think when it comes to HT there's a lot of unanswered questions WW.

Even the specialists don't know everything.

My biggest question is , people with low stats , well contained and want to go for Radiotherapy, y do they have to have HT as well, isn't it best to keep that in case needed later.

Ok if aggressive, spread out etc then I understand.

They probably take a belt and braces approach but then we all know about HT side effects, how many go thru needlessly.

Ok , rant over, back to tuna and cucumber  sandwich

All the best

Steve 

Hello Steve - brilliant question! I'm afraid I don't know the answer. What I do know is that the oncologist told us the following:

1. People with low risk cancer need only have HT for 6 months - 3 months before RT and 3 months after

2. People with high risk cancer need HT for 2-3 year if they choose the RT route

3. There is no evidence to support the length of time people with intermediate risk cancer should be on HT

My big fears for my husband are:

1. The side effects - both short term and long term of the HT

versus

2. The risk of the cancer taking over if the HT is stopped too soon to mitigate those risks

Hmmm! No easy way out of this !

sorry, don't remember your OH stats and history  so I can't sit in my consultant's chair and give my view........................

only joking

but I go a long with what u have said   6 months for low risk, didn't  know about that timescale in place 

Steve

• Thankyou for your response, it really helps to have input from others here. We have an apt with consultant this week, and will definitely ask what would RT do. Thanks again.

Good luck, let us know how it goes

Steve