PSA response on Docetaxel

[Cancersucks]

Some newly diagnosed men with high volume metastatic PCa begin Docetaxel immediately after initiation of hormone therapy.  Some studies have linked PSA response (>50%) during chemo  to longer survival.  My question is: How do you know if you are responding to chemo if your PSA is dropping or if you are still androgen dependent?

[Hidden]

Guess and guess only. When I took my chemo trail that included among other drugs Doxy, PSA response, Blood work, and MRI and CT Scan. Interesting ending question.

The hypothesis for the trial that I underwent was, "As a working hypothesis, we suspect that the transformation from an androgen-dependent to an androgen-independent phenotype is mediated by the expansion of an androgen-independent clone already present at the time of androgen deprivation. If this model is correct, then it would be desirable to bring treatment to bear on the androgen-independent component when the corresponding tumor burden is minimal. Thus, we view the androgen-independent component as analogous to “microscopic residual” or “micro-metastatic” disease for which adjuvant chemotherapy has shown to be effective in other contexts."

Keep kicking the bastard,

Gourd Dancer 

[struwwellpeter]

An elevated LDH (lactate dehydrogenase) test will reflect tumor death.

[Cancersucks]

LDH was almost 500 before chemo.  Onc believes "rogue" cancer exists, resistant to all treatments.  PSA was 18 at start of chemo, four months after initiation of lupron and flutamide.  After 6 rounds of chemo, PSA was 31.  Absolute nadir happened after 3 rounds, which was 12. Was nadir due to lupron or chemo?

[JoelT]

I don't know if at that moment it is an important question.  What we do know from ASCO 2015 is that men who are hormone naive and newly diagnosed with very aggressive disease do have a longer survival if they receive early chemotherapy than if they go the more traditional route of just ADT at that juncture.  

What is important is that you are responding.  Chemo at this stage is usually for a shorter duration.  After it has stopped you should still continue to remain on ADT, which you will remain on for the rest of your life.  At that time you measure your testosterone level against the changes in your PSA to determine if you are castrate resistant. 

Hopefully, I have answered the question that you asked.

Joel

[Pennysue1 in reply to JoelT]

Mike did not respond to the chemo texotere (sp ?) cancer had left prostate & went to his lymph nodes - took radiation for 5 wks every wk day - plus zytiga 1000 mg a night - been on zytiga for 4 months now - little side effects - also on lupron every 3 months plus prednisone twice daily to protect liver. Seems to be working - only noticeable side effect is a little tired -

[Bob_H]

Sounds like something I should know too.

[Cancersucks]

Upset PSA never came close to one or below.  Testament to how aggressive cancer is.  Testosterone is still at 5.

[DFZ4835]

This is the way my oncologist started me and it seemed to stop my pc with bone mets. My Gleason score is 8 - 9 my PSA has never changed much. The highest I can remember it being is about 3.5. Right now it is undetectable. This is a irritation for my doctor because this marker is unusable for them.

Dennis.

[Hidden]

Periodic scans are the way to understand progression during after chemotherapy. Psa is not a perfect indicator especially if there is visceral disease.

Speak to your oncologist about this topic. I am not an expert but this has been my experience.

Bill Manning

[Subasighejinadasa]

Even after given chaemo why PAS

Going up. now my PAS 390