PSA drop

[Blair77]

Prior to my husband's third chemo infusion his PSA was 20 dropping from initial diagnosis at 1044 in January of 2017. I had hoped for an even lower number and was quite disappointed with 20. I fear the doctor will suggest adding more cycles of chemo beyond the expected 6. Am I jumping to conclusions or should the chemo be knocking the PSA much lower?

[Dan59]

The good news is that it continues to drop, how are the side effects now? 1044 to 20 is a huge drop. I was diagnosed at psa 148 and after 3 months it had dropped to 20, It continued down to 3 and never went below that, that was 10 years ago, currently I am going for 8th chemo on Wednesday and latest psa is 67 down from 95 5 months ago. I am wondering if he is considering zytiga at this point, Zytiga is an oral med. I wish you the best and know that we are all here for you.

Dan

[Blair77 in reply to Dan59]

I am considering oral Zytiga after 😉. I'm not sure about the doctor but I have been looking at clinical trials. The chemo is still knocking him down pretty good, nothing terrible but definently not the quality of life a 47 year old wants to have. Thanks for the feedback and moral support!

[Dan59 in reply to Blair77]

I was diagnosed at age 49, Keep us posted on his progress and let us know what the side effects are, there is a good chance some would have effective remedies for those side effects,

all the best,

Dan

[markgo]

My PSA was 310 on diagnosis in December 2016. Started Doxetaxel in early January. The PSA got down to 4 after 6 chemo sessions. My oncologist suggested more, I have now done 8 sessions and the last planned is this week. Last PSA was 2.6. I have just started Zytiga as well on the basis of the recent studies that show that it works better early. I hope the PSA goes lower with this but I will see with the next couple of tests.

Mark

[ctarleton]

It is good that the PSA has dropped as far as it has. How much of that drop was due to the Lupron and how much to the chemo, who knows. As already mentioned, if future scans, symptoms, and/or PSA trends start back up, another agent like Zytiga could be a future treatment option. Or possibly Xtandi. Or, while asymptomatic, perhaps some early Provenge, or a clinical trial with an immunotherapy flavor.

First, however, in light of your husband's young age and earlier history with another cancer, it might be good to get your UCSF specialists to refer him for Genetic Testing for possible inherited mutations. It might open the door for some other treatment modalities, besides the standard prostate cancer standard of care drugs and agents.

While consulting at UCSF, I was referred to the Hereditary Cancer Clinic, part of the UCSF Center for BRCA Research.

ucsfhealth.org/clinics/here...

The test I got was a saliva test that was sent to Ambry Genetics in Southern California.

Here's the current version of the test I got nearly a year ago.

ambrygen.com/tests/cancerne...

Charles

[Blair77 in reply to ctarleton]

Thanks Charles. He was tested with cytogenetic testing called the UCSF 500 oddly enough he didn't have any mutations other then your standard run of the mill prostate cancer mutations. I would post the report here but I'm not sure how to post graphics.

[RangerTug]

As a non medico, I think your results are fantastic. A drop from 1044 to 20 after 2 sessions I would suggest is a much better result than I would expect. I am not sure why you are overly concerned about adding a couple of sessions I would take whatever is working, In my case I was scheduled for 8 sessions at 21 days intervals. My PSA was 62 prior to commencement and last Friday was 1.7 My PSA had got down to 0.2 in December 2014 when on Xtandi, over the next 2 years it progressively increased to the 62.

Prior to my 8th session, my PSA was 2.3 and 2 months after session 8 had dropped to 1.7. To me this was a fantastic result.

How does your husband feel about the results ? It is more important how he feels about his results, not necessarily your feelings about the results. Your husband needs your understanding and support.

All the best and we are thinking of you both.

[Blair77 in reply to RangerTug]

He doesn't feel anything about the results. If you were to ask him what a good response was he wouldn't know . He doesn't ask or research anything he wants me to do it all.

[westjl2]

Good morning. My diagnosis and treatment plan sounds very similar. I wouldn't get overly concerned about the PSA numbers at this stage of treatment. It will almost certainly come down much further. I finished Chemo in November and continue on ADT. PSA has bottomed out at 1.3 from 76. I had hopes of it dropping to below .5 but Dr is not concerned. Have you looked into the Titan clinical trial for Apalutamide? Your husband may qualify for it. I have been on it since December. Not sure if I am getting a placebo or the real drug but the big advantage is that you qualify for regular blood work, bone and CT scans. Like others have said stay positive because this will be a great help to your husband as well.

[Hidden]

I started at 845. went through 6 rounds of chemo which took it down to .5. After one year i bottomed out at .06. I also took Lupron and Casodex. I would wait until the chemo treatment ends before being overly concerned. My number was somewhere around 23 after my second round.After my third it was 10.7. After my sixth it was .5. It takes time. As my oncologist continues to tell me," it's a marathon not a sprint". Your on track, have patience and faith, That psa will continue to drop. I'm nearly three years into treatment and my psa is .5. I consider my three year success due to the six rounds of chemo nearly three years ago. I know it can be scary, been there, done that. Wait until it drops below 1, you will be doing your all time best happy dance. I did in my front yard and the neighbors nearly called the police.

[MrJack]

we keep using a particular treatment as long as it is working or as long as our body can take it.

so from 1000 to 20 is good, keep using it until it reaches 25 at least, then switch to something else. I would think, I am not a doctor, you do play a part in the decision making process.

peace, god, and luck be with you.

jack

13 rounds of chemo and psa is now 10

[MelaniePaul]

Hi everyone.

Reading this thread makes me feel really positive.

Firstly, I would like to say that I agree strongly with everyone else here saying that your husband's PSA drop is a fantastic result. I wouldn't worry at the moment and keep doing what you are doing, even if the oncologist suggests to do a couple more rounds of Chemo.

Also, if your husband doesn't have any wish to research anything himself, that is fine. Maybe he needs his strength to stay positive and to get better. My husband is not too much into researching and thinking about it all either, but I think that is fine. Our husbands are the ones who have the illness, and we are there to support them.

It sounds great to use the Chemo and afterwards another treatment to keep it all under control. Chemo and afterwards Provenge or maybe Aberaterone again?

Mel and Paul.