Symptoms worse not better

[Blair77]

My husband just finished chemo. His PSA has dropped from 1044 to 13 in the last 6 months. However his urgency to pee has increased. Shouldn't this be getting better? Does the prostate shrink as the cancer burden lowers? I'm confused as to why his symptoms are not improving if a drop in the PSA signals a lower cancer burden. Ideas?

[Darryl Partner]

Consider using the Cancermatch app ( iOS or Android) to document the quality of life and side effects changes. Your doctor should find that Very helpful in adjusting his treatment

[ctarleton]

If most of the PSA was being produced in prostate cancer cells in the "mets" outside of the prostate, that might account for the majority of the drop in PSA from 1,044 to 13 in the first 6 months of therapy.

(I was diagnosed in Nov 2013 at age 65 as stage IV and very metastatic to lots of bone and lymph nodes, with a normal-sized prostate gland, and a PSA of 5,006. After 6 months on a Lupron-based treatment, my PSA dropped to 2.5, and reached a nadir of 1.0 after approximately 12 months. My prostate size and (lack of) urinary symptoms remained the same.

In the 3 years and 9 months since first diagnosis, my disease eventually became resistant, and my PSA rose as high as 95. My prostate size and urinary symptoms again remained the same.

Since going on Xtandi 9 months ago, and also taking several other medications, I have noticed some uptick in urinary frequency (possibly due to washing down all the capsules and pills, possibly due to have a bit more abdominal fat pressing down toward the bladder, possibly due to my bladder sphincter being 69 years old now ???), but the size of my prostate, itself, still remains the same.)

Charles

[RangerTug]

I would be over the moon with results like that. Urgency and frequency are not necessarily related to PC. Talk to your Doctors about medication for the frequency. I think it is the least of your worries and I would focus more on the results of the chemo and the dramatic reduction in the PSA

[pjoshea13]

I suspect chemotherapy-related inflammation.

I wrote a few posts on inflammation a while back. Also, a number of posts on polyphenols that reduce it.

-Patrick

[eggraj8]

for me I find very little relationship between PSA, prostate size as measured by scans and frequency of urination. I wake up about 6 times a night needing to go to the bathroom. I have measured the amount of urine I am putting out and it is significant so I need to go. My urologist Dr. Leddy at MSK has suggested that the problem is that my body is generating the urine at night rather than during the daytime and she was going to treat that problem but since my cancer now requires Chemo I have not tried that fix. While the urgency issue is a problem it is minor compared to my other issues.

[Neal-Snyder]

Yes, & the urologist may be able to refer you to a physical therapist who specializes in such problems. Biofeedback is very useful, with the guidance of such a PT.

Neal