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Cancer: Prostate Message Board

Cancer: Prostate Board Index

Hi again,

I have been pressed for time due to family health issues, so I will make this short and sweet.

Regarding Lupron side effects: were you advised about how to counter them? Are you doing countermeasures? (Very important!)
How long is your Lupron program – 6 months total? - looks like maybe a year, which would be long for an intermediate risk case, which I believe you have, but short for a high-risk case.

Regarding testosterone? When was that testosterone lab done? If much after the start of Lupron, a value of 312 is far too high. It would indicate at least partial failure of the Lupron injection. Lupron alone should lower testosterone at least to lower than 50 by this time, and probably much lower, such as below 20. On the other hand, the fact that you have side effects suggests that you are getting at least some benefit. A fault with Lupron can occur from several causes, including but not limited to faulty mixing of the elements before the shot and injection into butt fat instead of butt muscle. It would be wise to get another testosterone lab done now, which would at least be confirmatory and help rule out the possibility of a rare lab error, or would indicate some problem with the Lupron. Follow-ups every three months would make sense to me.

Regarding PSA: Yes, that level of 2.22 is surprisingly high for a program started in July. That’s another hint that something may not be working with the 6 month injection. Alternately, some patients have a high DHT level (dihydrotestosterone), which is a far more potent fuel for cancer than testosterone, despite being on Lupron. Ask your doctor if he will do a DHT test. Ideally, you want a DHT of 5 or lower. PSA can stay high if testosterone and DHT are not both in a satisfactorily low range.

Regarding that vacation: you really want the PSA to be below 0.05 (needs an “ultrasensitive” PSA test) before going on a Lupron vacation, if ADT with Lupron is your main treatment. However, you are using Lupron to support radiation for an intermediate case, and normally six months of Lupron would be considered ample. So there is a confusing picture here: possible inadequate response to Lupron per PSA and testosterone evidence; and the length of time on Lupron needed to support radiation for an intermediate risk case. Ideally, it would help to consult a “medical oncologist” who does a lot of ADT, including ADT in support of radiation. However, your usual doctor(s) may be able to help, especially the radiation oncologist. My impression, as a layman, is that urologists are not all that expert in ADT drugs. They tend to use them in kind of a paint-by-numbers fashion, though some are expert.

Are you taking melatonin? That old and cheap diabetes drug looks like it helps a lot with radiation effectiveness and reducing side effects of ADT, according to some pretty good but not yet conclusive evidence. I can explain further, or you can check previous information about melatonin on this board.

Good luck! :wave:

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