How to manage rising PSA after Leuprolide discontinuation?

Question

Hello doctor,

I was diagnosed with stage III prostate cancer fifteen years ago. Recently, my doctor recommended stopping Leuprolide to monitor what would happen and following up with a PET (positron emission tomography) scan. After discontinuing Leuprolide, my PSA (prostate-specific antigen) levels quickly rose to 1.3. I have attached the PET scan report for your review.

Please review it and let me know your thoughts.

Answer 1

Hello,

Welcome to icliniq.com.

I reviewed your query (attachments removed to protect the patient's identity) and understand your concern.

You received post-surgery radiotherapy and were started on Leuprolide, which suggests that either your lymph nodes or surgical margins were positive, or there was a prior rise in PSA (prostate-specific antigen). Based on this, I recommend continuing Leuprolide. Your PSA remained well controlled for many years and increased only after stopping Leuprolide, which indicates that the tumor is still hormone-sensitive. Therefore, resuming Leuprolide is advisable. Since the tumor tends to grow slowly, it is reasonable to wait 10 to 15 days until your follow-up appointment with your doctor.

I hope this information is helpful.

Please follow up so I can assist you further.

Answer 2

Hello,

Welcome back to icliniq.com.

I have reviewed your query and understand your concern. You have done very well so far. Restarting Leuprolide and discontinuing Casodex may lower your PSA levels again and control the PET-positive areas.

I hope this helps.

Please follow up so I can assist you further.