Advanced Prostate Cancer

Tumor positive for PSA, PSAP,weakly for synaptophysin meaning???

Reorganizing hubby’s med files I came upon his specimen report for the lung tumor and lymph nodes sample which said cells were positive for PSA, PSAP and weakly for synaptophysin.

He also previously had a Biocept circulating tumor cell blood test which never meant much to the doc who ordered it or to us. CTCs were detected at 7. AR analysis of CTCs by ICC: not detected.

Any opinion?

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That was good news. PSA and PSAP are proteins specific to normal (acinar) prostate cancer. Synaptophysin and Chromogranin A can become very elevated in neuroendocrine tumors. So the markers are prognostic for good results from taxanes (like docetaxel) and the hormonal agents. CTC counts above 5 can indicate metastases, which you knew already. They looked for the AR variants among the tumor cells but couldn't find any. Certain AR variants (like AR-V7) can indicate that Zytiga or Xtandi won't work very long, so their lack is a good thing.

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Thank you so much Tall_Allen. His PSA did drop a bit after 3 weeks on Xtandi so we are happy.

I appreciate your expertise.

Mary

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I am very dense so forgive this question. Is his lung tumor attributed to his Pca?

Good Luck and Good Health.

j-o-h-n Thursday 03/01/2018 7:33 PM EST

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Yes John. He had two lymph nodes and another lesion removed from his left lung 2.5 years ago. They were found using C11 acetate scan which proved accurate.

He has since developed three more spots same lung shown with Axumin scan.

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The reason I asked was because I have melanoma stage IV Lung cancer (not related to my Pca) and it's being treated with Keytruda and so far with excellent results. The Immunotherapy cost is $30K per treatment. So I wanted to inform you of the treatment and thought it may be something your husband should look into. Well,

Good Luck and Good Health.

j-o-h-n Friday 03/02/2018 2:08 PM EST

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Thanks J-o-h-n, Is the $30,000 per treatment after insurance? I have been reading here about Keytruda and how it can be approved for PCs Mets to the lungs under certain circumstances. They sure spend a lot on advertising tv ads for it.

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