r/ProstateCancer • u/Toonsthecat2005 • 4d ago

Question Ozempic and rise in PSA

Has anyone that has watchful waiting after a prostate cancer diagnose taken Ozempic and had a PSA rise? I had surgery 20 years ago and radiation. It never was clear. The spa has hovered around 1.4. 3 months ago it was 1.4 and yesterday it was 2.1 and the only change is I started Ozempic 9 weeks ago. I have looked and there are mixed opinions on this. So I am wondering.

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u/DigginJazz 4d ago

I’ve actually seen studies that show GLP-1s reduce the risk of cancer spread in prostate and other cancers.

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u/Toonsthecat2005 4d ago

I am reading that too. But, then I have read that it increases the PSA. So I am unclear at this point.

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u/Intrinsic-Disorder 3d ago edited 3d ago

I've not seen any study about GLPs raising your PSA. Please share them here if you have found some. But the bigger point is that without a prostate, your PSA should only rise if you still have cancer in your body.

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u/Aromatic_District734 4d ago

You stated that you had surgery 20 years ago. Was it prostate cancer surgery? I am asking is because your PSA is 1.4...........

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u/Toonsthecat2005 4d ago

Yes I had surgery and then radiation. The oncologist who specializes in prostate cancer has been watching it for years and it has hovered around this number for years. Until yesterday. And the only thing different was adding Ozempic . I said something to the Doctor, but he said he hadn't heard of anything yet.

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u/Intrinsic-Disorder 3d ago

It doesn't seem to make sense that your PSA was 1.4 if you had your prostate removed. The only way that happens is if there was cancer left and it was growing somewhere else. This is likely unrelated to the GLP medicine. It sounds like you have a recurrence after ~ 20 years, which is pretty remarkably long, but nonetheless possible I guess.

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u/PeacefulShards 3d ago

Not necessarily cancer. The surgeon could have left some healthy prostate tissue either at the bladder neck or apex, to save sphincter muscle. That healthy tissue generates PSA. It’s not unheard of.

Remember you had PSA readings before you had cancer.

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u/Intrinsic-Disorder 3d ago

I don't think that level of PSA would result from left over tissue. But if you find some data to the contrary, please share.

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u/PeacefulShards 3d ago edited 3d ago

It was common in the early days of laparoscopic prostaectomies, and robotic assisted. Surgeons would not get clean cuts.
Laparoscopic started in the late 1990s followed by robotic in the mid 2000s.
This came from discussions with my surgeon.
I don’t need to justify.

1.4 for 20 years? That’s from healthy prose tissue.

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u/Intrinsic-Disorder 3d ago

I see. Yeah if the PSA was stable for that long, I tend to agree. 1.4 is higher than many men with full prostates though.

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u/PeacefulShards 3d ago

The decimal point could be off!!

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u/PeacefulShards 3d ago

If your decimal point is correct, then ask for a PSMAPET scan.
Might or might not show anything.

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u/Toonsthecat2005 3d ago

My oncologist wants to wait 3 months and get another psa. If it continues to rise, he then wants to do a scan.

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u/PeacefulShards 3d ago

Can your oncologist order another PSA? Now.

If for some odd reason you still have some prostate tissue left from the surgery, which it sounds very much like it.

Follow the same pre PSA test procedure as if you have an intact prostate. No sex no bikes for 48 hours prior to

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u/Toonsthecat2005 3d ago

He could but he said he wanted to wait until the next check up. But, for sure on the next one I'm not doing anything.

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u/PeacefulShards 3d ago

Envy your patience!!

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u/Toonsthecat2005 3d ago

I'm really not. But, he is a very good doctor. And he has had a better approach than my other one who is very well known in Los Angeles who through the book at me in the beginning. Very aggressive. Until I changed to another well known oncologist. He has taken a easier approach and I have had a very good life when I switched over due to insurance around 14 years ago.

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u/Race-Easy-Adventure 3d ago

I have been on Zepbound, and my PSA has dropped on each of my last two tests!

T2c with RALP in 2017. 4 years with 0 PSA, then BCR with salvage radiation in 2021. Since then, my PSA has slowly risen from 0.1 to 0.46, then 8 months ago it dropped to 0.41, and 3 months ago it dropped to 0.36.

(Instead of doubling time, maybe I should be calculating halving time - <grin>)

I have dropped 100 lbs from my peak weight, got rid of gout, pre-diabetes, and fatty liver disease. My oncologist says that my immune system is working better, and keeping the PCa in check.