Your case is interesting. Its what makes evaluation of provenge so difficult' The way I read it is that your psa rose only 0.30 points and that was a failure of Lupron? The lymph nodes were probably never biopsied. Slightly enlarged lymph nodes are not indicative of prostate cancer.Were they prostate ca or something else? Could easily have been something else but the insurance company probably only required a psa of 5 and the soft finding of two lymph nodes. A doc would be confused as to what is at work here. You probably still remain on lupron and the casodex was given about the same time as provenge. Was your serum testosterone measured before casodex was started? Often patient's testosterone levels are high on Lupron and the addition of casodex brings it back down. That alone can produce a response. Now its only a year and a half later and you had slow growing disease to begin with. So what caused the response? Provenge? Casodex? The continuation of Lupron? Was your prostate cancer re biopsied before provenge? Was there some other reason for a slight 0.3 rise in psa necessitating provenge? For example prostatitis, a rectal exam, sex or even a hard bowel movement can affect psa since you still have an intact prostate making psa as well as the possibility of cancer. Repeat psa;s can fluctuate quite a bit but this one happened to meet the insurance companies cut off. Lymph npdes fluctuate in size too which is why size on ct scan (and yours was a slight enlargement) isn't very reliable.
Im glad you are well. Question such as these are what are asked for example in the publication of case reports and the minds of docs. Its what makes evaluation of provenge difficult.