Prostate cancer case with raised PSA

Chief Complaint A 66-year-old male has h/o prostate cancer. He underwent prostatectomy, preoperative PSA was 9.5ng/mL, postoperative PSA on followup was 0.8ng/mL. The patient refused for adjuvant radiation therapy. Instead, he wants to go for exercise and dietary changes Investigations Bone scan and CT scans were unremarkable for metastases But his PSA started raising again. Treatment What should be done now?

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Best option in this case is 1.Tab Bicalutamide 50 mg O.D for at least 2 years 2.Inj Leuprolide 22.5 mg every 3 months for 2 years 3.Calcium and mineral supplements

Bilateral orchidectomy is another option
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