PSA dropping

[easeytiger]

Just completed my first month of Zytiga/prednisone alongside Firmagon. My PSA at diagnosis was 55 two months ago and went quickly to 68. My results today indicate a drop down to 45. Not sure whether this is good or bad. I’ve been advised that it’s early and one month is too little to see really low numbers. Any thoughts on this?

[noirhole]

Numbers going down that is always a good sign. Good luck.

[Chiquis]

My husband's PSA was 8.7...a month after First Firmagon shot, Zytiga and Prednisone drop to 7.4

2 months later 0.1 Always is a good news to me when PSA drops.

I wish the best to you.

Erika

[Dr_WHO]

The fact that it is going down is good news. You have to wait until your next reading to see how good. Hopefully it continues its downward slide.

We are all pulling for you to get that low number!

[Hidden]

Always is good to know that the PSA is going down with treatment. The dynamic of the PSA changes is complex and probable related among many things to the tumor load and not only to the response to the treatment. I believe it can go slow if the tumor load is large.

It may also has to do with how much cancer is hormone sensitive and how much is already castration resistance. PC becomes castration resistance when metastatic.

Perhaps you could discuss with your doctor the possibility of having a Gallium 68 PSMA PET/CT done to know localization of metastasis with great precision and if the cancer is PSMA positive.

UCLA has an ongoing clinical study for GA 68 PSMA PET/CT and may be others in the USA. (clinicaltrials.gov search for Gallium 68 and prostate cancer).

If the cancer is PSMA positive you could qualify for Lutetium PSMA 177 treatment. This treatment has been developed in Europe, in particular Germany and has a lot of science behind it.

It is being used in at least 7 countries (Germany, Austria, Netherlands, Turkey , Australia and South Africa). Please take a look to the following articles:

ncbi.nlm.nih.gov/pmc/articl...

The next article has interesting images of what this treatment can do with the metastasis.

drive.google.com/file/d/0Bw...

I had this treatment in Munich in 2016 and my metastasis were gone after only one treatment. I had a multitude of lymph nodes metastasis in the pelvis and abdomen, so many that I was not a candidate for local radiation or surgical extirpation.

The treatment It is an IV infusion of a solution of Lu 177 PSMA ligand. Then one has to stay 3 nights in the hospital so the radioactivity washes out.

This treatment kills hormone sensitive and castration resistance prostate cancer cells. Since castration resistance (the very bad cancer) has more PSMA it gets "bombarded" more by this treatment.

Usually, there are not mayor side effects. If the patient has a large amount of bone metastasis it could be side effects caused by the radiation affecting the bone marrow.

The cost in MUnich is around 12K euros for the treatment and may include a Ga 68 PSMA study or not. If it is not included the GA 68 study cost around 2.5 K euros.

If you are interested and need more information, please let me know.,

Best regards

Raul

[Izab in reply to Hidden]

izab

I am following lU 177 very closely. Its very encouraging to here that soft tissue mets gone after 1 treatment. We have a member in advanced pc support group who has had 1 or 2 treatments as a last resort and will find out 26/2 how he is doing.

My next option is Xtandi (may be unsuitable for me) so may try 1 or 2 treatments of Lu 177 will have to pay as in Western Australia there are no trials at this time. Only in Melbourne.

[Hidden in reply to Izab]

Hi:

Lu 177 works with most of the patients. I think that the data in the initial papers is skewed because when they started they treated patients with very advanced disease.

I believe it is worth to try since the side effects are minimal or none, It is an IV infusion for 1 hour and then 3 nights in the hospital for the radioactivity to wash out.

Besides it destroy hormone sensitive and castration resistance cancer cells. They have seen patient with castration resistant PC to go back to be hormone sensitive after the treatment.

Nothing to lose except for some money and a lot to gain if it works.

This link from my google drive has the articles I read before going to Germany:

drive.google.com/file/d/1HG...

Please keep me posted about the results of the other members who recently had the treatment.

Best

Raul

[Hidden]

Too early to tell, but as long as the direction is downward it's all positive. Ideally you will get a long, slow decline to a low nadir. That's what we are hoping for you. Wishing for the best and more lower numbers.

[JamesAtlanta]

Congratulations! 🎉 Down is good!

James

[Scruffybut1]

My experience with Zytiga is a big drop for each of the first 2 months and a constant 0.03 or 0.04 every month since. Now on 18 months. Good luck and good success for you.

[Forces]

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