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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3533
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I am a 79 year old male and I have prostate cancer since mid

Resolved Question:

I am a 79 year old male and I have prostate cancer since mid 2008.
I have had radiation treatment and 3 monthly injections of Leuprorelin since then . A year ago I was prescribed Bicalutimide due to my PSA rising to 28. It has now risen to 40 and my urologist advised that I should stop the Bical. without any additional treatment. (He explained why, i.e. it may be feeding the cancer) I am a bit concerned about this. Can you advise?
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Tharun replied 1 year ago.
HI

Do you have symptoms ?

What was the bone scan report ?

Any bleeding in the urine ?

Please let me know

Dr.Tharun
Customer: replied 1 year ago.

No discernible symptoms.


 


Bone scan: "No obvious metastatic bone disease seen" - Date: end May 2011


Followed by MRI mid June 2011: "Appearances suspicious for recurrent/residual tumor on right side of prostate gland with no extracapsular spread".


No bleeding.


 


Will copy and attach full report tomorrow if required .


 


Thank you for replying.


 


 

Expert:  Dr. Tharun replied 1 year ago.
Hi

In Absence of symptoms and obvious bony metastasis,sequential hormone therapy is recommended.

the next step is withdrawal of the hormone therapy. So in your case withdrawal of bicalutamide. This can cause the PSA to fall in 3- 4 weeks. PSA has to be monitored carefully during this period. This response is usually temporary and provides a break before we start on second line therapy.
If you had symptoms and evidence of bony metastasis, then the situation would have been different. In that case chemotherapy holds more benefit than second line hormone therapy.

So in your case, stopping bicalutamide would be the next logical step to follow.

I hope this answers your question.

Regards

Dr.Tharun

Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3533
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Dr. Tharun and 2 other Urology Specialists are ready to help you
Customer: replied 1 year ago.


Thank you Dr Tharun


That has put my mind at rest to have an expanded opinion on the reasons for stopping Bical. It also gives me a view of what should happen on my next visit to hospital and what I should expect in 3 months time from my Urologist.


J. Wright

Expert:  Dr. Tharun replied 1 year ago.

You are welcome.

Do let me know of your progress.

Dr.Tharun

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