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Androgen-independent prostate cancer

March 11, 2009
  • By Harvard Prostate Knowledge


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Doug McNeill
June 3, 2018

If one has had his prostate removed and two years later PSA is again rising (0.01 – 0.01 – 0.04 – 0.17 in 6-7month testing intervals) with 0.17 being 17-months following surgery) is orchiectomy a reasonable approach for addressing Androgens if the man is OK with that?

What “other” side effects should be considered? I am 76-years old.

June 1, 2018

I have Stage IV prostate cancer and have been on lupron for two years since diagnosis. My
PSA dropped from 60 to 0.06 since then and has held at that for over a year. Mayo wants
to do proton radiation therapy on my prostate and a few nodes ASAP. I am 77 yrs old.
Any comments or thoughts. Thanks

December 27, 2017

As much as I have tried to read and gain knowledge on this topic, this was certainly the best explanation. I can understand most of it!..which is great, since it all can be a bit confusing when a person, like myself, is not in the medical field. My direct question is regarding the regular followup testing of possible side effects while taking any of these drugs, specifically Lupron. Even though it is too late for my dad, I would like to know if you think if it should be standard practice to do such monitoring or not. My dad, who was an extremely healthy 80 yr old with no health issues other than a prior short bout with colon cancer almost 20 yrs ago, suddenly died in Oct this year. He had a stroke caused by a brain hemorrhage that is a side effect of the Lupron medication.Even though he had no current indications of any re-occurence,his oncologist strongly recommended him to take the Lupron shots as a ‘preventative’. Trusting him, my dad took the shots believing it was in his best interest. Fast forwarding to the night of his stroke, the attending Neurosurgeon, immediately ordered a CT scan, because she said this side effect was common in Lupron patients. And that regularly monitoring would have possibly detected the beginnings of he brain blood leak long before having a stroke. So, why wouldn’t my dad’s long time oncologist have completed CT scans regularly to check this?…On a side note…the night this happened, the attending nurse called the oncologist and informed him of the situation and asked if he would he be coming to see my dad, to which he replied that he would not be coming and there was no need to be concerned that the Lupron shots had anything to do with this hemorrhage. So…kinda thinking that was a dead giveaway….Anything that you may have to say to enlighten me would be so great. Thank you for your time. Mary Holzinger

Ted Lynch
October 21, 2017

Ted. I am 59 years old in may 2014 my PSA test showed a level of 10. By aug 2014 my PSA was at 40. I was refered to a urologist. A biopsy was done. 12 samples were taken and 11 came back positive. The diognosis was stag 4 with a gleeson of 9. Before surgery I started bicludimide after surgery I started luprion. 3 months after surgery my PSA was 1.5. 6 months after surgery my PSA was 4.2. There was no matesteses on the Ct or bone scans at 6 months. I started a 40 day radiation treatment. At 9 months my PSA was at 2.5 at one year my PSA was at 2.1. My luprion shots were every 6 months. At one year my bone scan showed a small legion on the lower lumber spin no masteses detected. For the rest of 2015 and 2016 scans showed no masteses and my PSA varied from 2.1 to 3.5. In 2017 my PSA started rising the last two test were 5.4 and 5.3. I’ve been on luprion now for 3 years I’m worried that the cancer has gone androgen independent. After reading your article and others such as articles on the parten scale I’m cancerned about androgen indenpendance and survival rates. Please I would like to hear your thoughts. Thank you

January 8, 2017

Harvard as usual publishes comprehensive articles like this which are very informative. I’ve had questions about hormone therapy for which I’ve never been able to get answers . Now I have them even though as usual with this disease many questions have no definitive answers due to lack of data or the heterogeneous nature of this very complicated disease. I thank these doctors and all the others who toil to find answers , more treatments and hopefully more cures to this hideous disease.

Deborah Sawicki
November 7, 2016

My husband was diagnosed with prostate cancer 3 years ago. He received radiation therapy ( 40 treatments ) and Lupron injections for 2 years. During this time his PSA was undectectable. He has been off the Lupron for over a year. In June his PSA level was .064, September it was .067, it was recommended that he start Lupron again. He opted to wait. In December he will have his PSA and Testosterone level checked. The radiation center said if his PSA goes to .1 then he will have to restart the Lupron. His initial biopsy showed positive for 3 sites in the prostate. Gleason score of 7 on 1 site so radiation and hormone therapy was the recommended treatment. After reading the article we arewondering if the Lupron should be held off for a while and use the watch and wait method. He is 69 years old. Would appreciate your thoughts. Thank you, Deborah Sawicki

Ann Messina
September 26, 2016

My father now 91 has been on hormone therapy, Luron for over 10 years with two different “vacation” of sis months or more. Today for the first time it was discovered he now has a raising PSA and is Androgen independent. This article was very helpful moving forward in his diagnoses prior to visiting his oncologist. We will be informed!Thank you!

J. Martin
August 23, 2016

I would like to second Greg Edwards comments above. Very informative and positive article. I am age 69, stage 4, with widespread metasis to bone and lymph nodes. PSA over 1,000. I have not started treatment yet due to recovery from a cancer enduced pulmonary embolism and now on anti-clot medication. I have a hematologist/oncologist and a urologist on my case. I am considering orchiectomy, but I will hear what my doctors recommend later this week. My wife and family are suffering emotionally and I can only hope that hormonal therapy will buy some time for us all. Thanks for the opportunity to express myself.

Beverley Vasquez
August 9, 2016

I am here to testifies on how Dr Odia help me to cure my sickness called CANCER OF THE LUNGS which has been eating me up for 2 years and 4 months, and when I go online I saw his email on how he cured so many people, so I emailed the Dr and tell my problems to him, and tell all his necessary needy for the healing, after that day he gave me an assurance of 3 days of his herbal healing, and said I should go for a medical check up on the 4th day of which I get to the hospital the new result now shows that the cancer was gone,And now am so happy and free from it thanks to Dr Odia. Please if there is any one in need of his help should kindly contact him on his email address ( drodiaherbalistcenter @ gmail . com )

Debdas Mukerjee, Ph.D.
June 27, 2016

Very Informative article.

I am a cancer researcher. Currently retired and ‘am 83 years old. Apparently in good health, very active and walk every day more than 3 miles.

I had Glesson Grade 4 + 3 Prostate cancer diagnosed with PSA level 0.16ng/mL in 2007 and had prostactomy in 2008. I has survalance radiotherapy in 2013 when the PSA level was found to have raised.
April 2016 MRI revealed tumor nodules in the peritoneum. PSA and testosterone levels were 0.89ng/ml and 278 ng/dL respectively. No tumor in the bone. On May 20, 2016 I was injected with Firmagon 120 mg + 120 mg. I started taking 50mg of Bicalutamide by mouth daily from May 21, 2016.

On June 24, 2016 my testosterone level came down to 20ng/dL and PSA 0.89ng/mL. My oncologist started me with leuprolide 22.5 mg IM. I am continuing to take Biculatamide.

As I read the literature, I find that cytotoxicity of Taxotere overexpresses the androgen receptors and other adverse effects on the patients.

Realising that androgen independent prostate cancer cells can synthesise teatosterone from cholesterol, I would like to get your opinion on treating castration resistent prostate cancers for polyadenoside duphosphate ribose polymerase inhibition with olaparib. (Mateo J et al. N Engl. J Med 2015 Oct.29: 373(18):1697-708).

June 17, 2016

What a wonderful informative complete article. learned a lot and it’s very positive and not scary. I also have a question. MY boy friend had his prostate removed in 2004 now he is getting lupron shots since sept of 2015. Ofcourse they are watching his levels. So my question is the latest blood test shows testostrone 880 and psa 0. His testostrone in feb 2016 was 8 and psa 0. He is going for another round of lupron. I am very happy that psa is 0 but also confused. would you please email me the answer what does this mean? thanks and keep up the good work

Dennis Doyle
May 21, 2016

Wonderful Article. Revealed to me one should not be suprised or overly disappointed when first line hormone therapy stops working,.brings home the point of how tricky PCA can be whether you subscribe to the theory that you have androgen independent cells, or normal cells with ultra sensitive receptors that can live off low levels of testosterone.

Dyke Davis
May 7, 2016

Great Article:
Learn everytime I read an article with this type format even though it covers little on the Immunotherapeutic side I was impressed with the therapeutic-response times and seeming understanding that it is best to consider any well researched therapy change, while the PSA is at its lowest point and begins to rise.
I say this because I am rising .070 ng/dL daily after seemingly nadir at .550 ng/dL that is now .690 ng/dL after a little over (2) weeks on combination Enzalutamide/Sipuleucel-T, but I think I maybe having an drug-drug interaction with my other medications and have begin to find precedents in stopping some and switching some to other types to improve my existing therapeutic potency.
Troubleshooting I am learning is part of the therapeutic approach before looking at failure or switching therapies…awaiting second PSA results since my .690 ng/dL rise and hoping for the best…Godspeed Everyone and Stay in the Fight…A THERAPY FOR YOU IS OUT THERE OR MAY BE ALREADY AVAILABLE, BUT YOU HAVE TO DO THE RESEARCH AND RISK!

david e seelye
May 7, 2016

DES, Prescott,AZ May 7,2016.
My PSA was 2.8 in December 2014, 5.2 June 2015 Primary doctor said nothing and I was dumb. New Primary January 11, 2016 PSA 334. Prostate biopsy January 26, 2016, out of 12 sample 1 3% Gleeson 6, sample 2 15% Gleeson 7, digital soft pliable!. CAT scan show numerous lymph node involvement. February started 6 month Lupron injection. Second opinion UACC showed positive PET scan, negative bone scan, two lymph nodes biopsied show positive for prostate cancer. Started Docetaxel April 7. PSA now 22, testosterone less than 20ng/Dl since March. 3 treatments done, 3 to 6 more on the horizon.

April 24, 2016

I believe that the docetaxel treatment should begin within four months starting Lupron.

Does anyone have data regarding the treatment of primary tumors, after mPCa diagnosis?

Andrew Campbell
April 1, 2016

I am about to start Lupron hormone treatment. What is the maximum recommended time between starting Lupron and starting Docetaxel?

March 26, 2016

I, 69 yr. old, 5’10”, 160lbs) was diagnosed with mPCA (pelvis and skeleton, no lymph nodes), totally asymptomatic at the beginning of 2016, Ashkenazi Jew with cancer (non-prostate) in both parents. PSA 28 on 01/02/2016, PSA 0.09 on 03/22/2016. BRCA2 mutation in biopsy sample. Have a germline normally only found in patients who have received chemotherapy.

Will start 6 rounds of docetaxel with carboplatins on 04/01/2016. Oncologists feels taht given the germline, the addition of carboplatins at the begining will be useful.

Any comments?

Greg Edwards
March 22, 2016

I’m in the process of being diagnosed (CT, bone scan) with AIPC .. This follows 6 years of androgen suppreson treatment.. I’m very grateful for the information, treatment advice, and the positive tone of the article.. Sincer thanks to all involved from the Dr’s to all ancelory support staff who made it available..

Sun City AZ

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