Prostate Cancer slowly coming back.

I was advised that in this scenario they would restart hormone therapy. A short break in your HT should not have any lasting consequences and intermittent HT can be an effective treatment protocol.

I guess you need to see how your PSA progresses before any final decision is made.

Best of Luck.

Rob

Thanks Sandberg. My urology nurse has suggested that there are other, new treatments. She has not been prepared to tell me what they might be as she says it all depends on a scan. I did think hormone treatment would be sensible. I shall be a patient patient.

Good luck with the scan and keep us informed of your progress.

Rob

Hi,

Sorry, not a reply to your question, but I just wondered why you had hormone injections as well as RALP when you were first diagnosed.  Were the injections after the histology results after surgery?

Sounds like you’ve really been through the mill with all your different treatments.  I hope there is something else to offer.

I believe that the hormone treatment was used to suppress my own hormones which presumably could be spreading the condition. There were concerns after the surgery that, because the cancer had broken out of the prostate near the interface with my bladder that cancer cells remained. I guess that is why I also went on to have chemo and radiotherapy.

Hello Vairon 

I am agreement with Sandberg I would have thought that a return to Hormone Therapy would be in order. My only other thoughts are if the scan shows a spread and not just confined to the Prostate Bed it would be the new "triplet therapy"  -  But don't forget I am not a professional.

Best wishes - Brian.

You have many options and the good thing is that your PSA is rising slowly.

My husband is on this rollercoaster of rising PSA since his diagnosis in July 2020. What I would stress is that he has a particularly rare aggressive form of advanced prostate cancer so I think timescales are compressed compared to the norm. He has been on Prostap since then and has been told he will stay on it for life. He has also had radiotherapy (33 sessions) and Chemotherapy (6 cycles of Docetaxel). He was on Bicalutamide for 18 months and when resistance was shown after a scan he changed to Enzalutamide which was effective for another 18 months. When resistance showed again he had the chemotherapy and we are waiting to see how long this is effective for. There are several drugs like Enzalutamide eg. Abiraterone, Darolutamide and Apalutamide which may be suitable for you (2nd generation antiandrogens). We have been told that additional chemotherapy could be a possibility with either Docetaxel or Cabazitaxel. Beyond that there are other tools in the toolbox such as Immunotherapy and Nuclear Therapy.

Good luck with the scan and come back with any questions.

My PSA reached 0.79 earlier this year and so I was sent for a PSMA PET scan which has revealed cancer in three lymph nodes in the pelvic region. I have spoken to a consultant radiologist who has suggested that I wait six months before having another scan because zapping the three lymph nodes may only buy a short delay as it is probable that it may appear in further lymph nodes and they can’t keep zapping. I have a face to face consultation in July to discuss what to do next. Does this forum have any advice to offer? It seems to be a waiting game. Hopefully you can see my history above. I am just wondering if I should press to be put back on hormone therapy. I had LHRH agonist for about 4 years with no side effects.

Hi Vairon .

From your information your PSA has progressed faster than a linear model would have predicted, plus the involvement of 3 lymph nodes in the pelvis would spark warning signs that things need to be got under control to prevent further spread. Hormone therapy would possibly shrink the existing mets but micromets might also be lurking although the PSMA PET CT is pretty good at picking up very small ones if your PSA at the time was above 0.5. Remember, none of us are medically qualified, but from a personal point of view I would prefer to stop things in their tracks now rather than wait to see where further mets develop. There is also some thinking that for younger men an initial aggressive approach to treatment gives a better long term outcome. The radiologist has given his opinion and that option will remain open even if you do go back onto HT, so get the oncologists opinion next month and take it from there.

Good Morning Vairon 

I agree with the post from Alwayshope above. My personal choice would be to return to HT now. (Keep the radiotherapy in reserve - I have already had my pelvic lymph nodes zapped) and in say 6 months time if your PSA is still on the rise another PSMA-PET CT scan then Radiotherapy.

Please keep us updated with your treatment plan when you see the oncologist next month.

Best wishes - Brian.