Hi,
My father has stage 4 PC with bone mets. Hes currently undergoing docetaxel. They took his PSA and it went from 170 to 100. He just had an MRI on his back because of a tumor on the spine. The doctor said the bone mets are spreading in the back. Is there a reason the PSA drops but yet the cancer is spreading? Anybody else with these results?
Sorry to hear about the progression. Not all PCa cells express the PSA so it's not the only thing you look at. He might want to consider genetic testing to see if his cancer has mutations that are treatable with targeted treatments.
Good luck with treatments and hoping for the best.
Thank you. I will look into if insurance will cover it. It's strange because his PSA has been a good indicator up until this point. The doctor basically said the cancer spread all over his back. I'm afraid to see what a full pet scan will show.
Where do you get this genetic testing?
Many people have used Foundation One, but I have no personal experience. Others here know more about it.
My understanding is that certain forms of highly aggressive cancer do not generate PSA.
I have been told that those particular types of cancer are quite easy to diagnose.
They are sometimes called I believe small cell cancer.
Thank you
There's neuroendocrine prostate cancer that doesn't make PSA. There are some blood tests that can help determine if you have it. Here's an article:
I also have bone mets, spine and hip, maybe others. PSA incresed rapidly to 7.05 after months on Xtandi and Eligard. Docs decided best step was docetaxel, 3 session and then see. OK, so after 3 sessions PSA "plummeted" to 6.95! However, doc pointed out, since this is second time I'm doing Docetaxel and cancer has spread and metastasized, it is not unusual for PSA to remain somewhat static. But he made a point that my Alkaline phosphatase declined from 533 to 224 in the same period which shows that the metastatic cancer activity in the bones has declined (could also be liver). Anybody have comment on this? Am now going to do 2 more sessions, every 28 days, with docetaxel.
The Psa is only one indicator of Pca activity. A Dr Hocking in Melbourne told me in 2017 that getting Psa low did not indicate that a man was free of Pca.
I'm 71, and the last PsMa gallium scan showed a picture like a dalmation dog, more black spots in my bones than doctors could count. Psa is only 7. I still cycle 220km a week.
ADT + Zytiga has failed now after 8 years, and maybe some cancer will not respond to chemo or LU117, so I know I have limited time.
"All the king's horses and all the king's men, cannot fix patrick, ever again" :-).
Between now and this time last year, Psa was held below 7 with ADT and Zytiga but the bone mets grew bigger and more numerous. We like to think positive, but we need to face being only temporary. This causes out mental anguish, we all want our loved ones to remain with us, but it is impossible, so all anyone can do is seek the best doctors and get some extra time before the inevitable occurs. I see my oncologist next Tuesday, maybe he has arranged for DNA analysis of my cancer to find the best chemo. He may have also referred me to a doc for Lu117. I am trying to buy time. I was diagnosed way too late in 2009 with Pca that was found to be inoperable when docs opened me up, and Psa was only 8. It probably had already spread everywhere by then, but mets were too small to be seen in scans, and they did not show up large enough until 2017. I knew that was what was likely, so I was not shocked. Docs thought I had no spread, but they were wrong. So how did it happen? Well, my PG had huge cancer amount with Psa only 6. So I should have been diagnosed at Psa 3 back in 2005, but Australian medical system says do nothing until Psa reaches 5. So I am someone who "fell through the cracks" despite regular PSA testing each year since age 48. About 40% have an RP, than that's the end of the Pca problem.
But 30% die from Pca despite all the medicals.
Patrick, my heart goes out to you. Don't lose hope. When your time comes, it comes. I am 78 going on 79 pretty soon. Similar situation with PSA at 6.95, was on Eligard and Xtandi but now only Eligard every 3 months; Xtandi didn't work. Hormone resistant now. Back to chemo. Yesterday had 4th session of Docetaxel which doc says is the best drug available for chemo . I wonder. After 3 sessions PSA dropped from 7.05 to 6.95. Big deal, huh! Have a number of black spots on hips, spine and ribs. Pain under control so far. Mental anguish an issue but one must learn to deal with it or get help. May The Force be with you. Am in Buenos aires, Argentina.
Hi Argentina.
My sincere condolences for you nations's loss to France , but hey, those boys were all busy no? 6 goals in a game.
Your luck with docetaxel is questionable because a Psa drop of 7.05 to 6.95 is hardly any drop at all, unless you got the decimal points wrong and drop was 70.5 to 6.95, which gives more hope. But a guy here had RP, then Psa went down, bounced right back up then had full RT, and Psa did same thing, ADT worked for onlt 3 months, and casodex made Psa go from 7 to 40, so it fed the cancer.... Then he had 10 lots of doectaxel, and in 6 months Psa went from 45 to 2, then back up to 7 and so now it
seems he's running out of options, all within 3 years of diagnosis. But he handled the docet without many side effects, He is under 60, and got fit, and played competition tennis.
He has Pca in liver and I am not sure what he will try to do next, maybe Lu117, or a stronger chemo.
Make no mistake, Pca kills about 30% of men diagnosed, and they all had hopes and tried whatever was available.
If a man does not have all Pca removed by a surgeon who is good at his job, and if the
Pca has not already spread, then he has a battle for the rest of his life, and with national health scheme here, cost to taxpayer can be $150,000 easily, and he might have to buy private hospital treatments which could add $100,000.
I know a guy who is still allive 25 years after diagnosis, so his cancer is a weak type of cancer, quite tame compared to my firnd here who is in real trouble after only 3 years.
Keep well, but Aunty Destiny is a bitch, no?
Yes, unfortunately, France deprived us of the trophy which we consider rightfully ours. However, notwithstanding and be that as it may, may the best team win. Not a football buff anyway! Argentina really didn't seem to have any strategy other than assume that Messi would make a few goals and the team didn't play particularly well either.
No error in decimal point. 7.05 to 6.95. Xtandi worked for 4 months then PSA started increasing asymptotically from 0.25 or so. indicating hormone resistance. Still on Eligard (leuprolide, I think) injection every 3 months. The protocol at the moment is one more session of Decetaxel on July 27 then take a look at blood and bone scan.
Have been battling this since 2008. Major symptoms are weakness, fatigue and pain in lower back when standing. These are typical side-effects of Eligard and Xtandi but not necessarily those of chemo, according to my oncologist. Difficult to exercise and walk when one feels so weak.
Don't wish to be morbid about this but like Oscar's outlook on death:
"Death must be so beautiful. To lie in the soft brown earth, with the grasses waving above one's head, and listen to silence. To have no yesterday, and no tomorrow. To forget time, to forgive life, to be at peace." -Oscar Wilde, writer (1854-1900) .
Take care!
Argentina lasted longer at World Cup than the Australian team.
I am a cyclist, but soccer appeals to me beacuse unlike Rugby there is less brawling. I will keep an eye on TDF when we get it here on TV. I raced for 6 years here in a cycling club in my late thirties to forties, so I know how to try to win.
I might get myself burried under a tree and wrapped in cotton cloth, so the tree can benefit. I see uttely no reason for a tombstone, and because I didn't breed, ppl will forget me within 5 minutes, but while alive I know I made many happy with my work, and so nobody will piss on me where I am buried. I won't mind if they do because I won't exist so won't be offended anymore by what other ppl do or don't do. I like Oscar's idea that life is too short to be always serious.
Gee, did he only live to 46? When I was 46, I'd quit cycle racing to concntrate on work because my knees were dodgy. The knees stopped the building work so learnt electronics that is good sit-down work, and then I got fat, but a knee arthroscopy at 58 got me back onto bike and I've cycled about 130,000 km since 2006. I have no idea if it slowed the Pca.
Patrick T.
Hey, incredible cycling. Cycled a lot as an adolescent but then got sort of lazy in this respect. Have an exercise bike which also makes a good clothes rack. Am not good at being consistent and exercising regularly. I also need to drink more water.
The medical profession maintains that practically...80% maybe... all men die WITH prostate cancer but not OF prostate cancer. Isn't that a relief!
Pain specialists are available to design a program of meds that will control pain due to bone metastasis. Of course, not everyone tolerates these drugs the same and they all have some kind of side effect which must be considered. The main point is that you must maintain a program consistently so that the pain meds are functioning above the pain threshold. I am currently on Tramadol 50 mg. every 8 hours and Diclofenac every 12. Feel no pain. Constipation is a problem with Tramadol, an opioid.
Don't know what the protocol will be if it turns out that docetaxel is not working and mets reproducing. Take it a day at a time, I suppose.
Am highly fortunate to have a loving wife, 59th wedding anniversary coming up, who is in great shape and loves to take care of me. Don't know what I would do without her!
Take care and may The force be with you!
Plenty men have no trouble ever with PG and these have Psa 0.7 at 40 and 1.0 at 60. But if one thing gets you, another does not.
But when diagnosed, its a very different lot of probabilities, and despite yearly Psa test docs found Gleason 9+9 so its going to kill me because they could not operate to cut it out. But I have a good life, millions are worse off than me.
Yeah, there are things for pain, but no worry about that yet. I am starting Docetaxel on 17 July. I have no clue what will happen, but will be able to get Lu117 and or radium 223 if I want it. So now I can still ride, and tinker about in shed, repair the the fencing here, and although I missed getting a wife who cared, I don't mind handling all this alone.
Patrick Turner
One always sort of thinks that bad as your situation might be, there is always someone who is worse. Not a real consolation though.
first time I had docetaxel 6 years ago - 8 sessions - worked very well and I didn't really have significant side effects that I can remember. Was working at the time. PSA Dropped to 0.03 and stayed there for 3 years! Doc said I was in complete remission! Ha! Then started to rise again swiftly, treated with Eligard, Xtandi (worked for 4 months) and now back on docetaxel, on which the jury is still out. We'll see.
Good to keep busy. Do what you like and enjoy doing. A good woman by your side is invaluable, let me tell you.
Good luck, Patrick. Whereabouts are you in Down Under?
Any ideas how long it takes before you know if the docetaxel is working?
Did blood test after 3rd session and PSA had barely gone down. What did decline however was the Alkaline phosphatase (ALP?) from 533 to 224 in the same period that PSA dropped from 7.05 to 6.95. I understand that this ALP is released by the liver and/or bones and a decline would indicate a comparable decline in the mets activity, presumably. I understand also that there is a further test one can do to determine if it is the liver or the bones that are responsible for the effect. In my case doc assumed it was bones (taking Calcium and vitamin D) as well as 10 mg. daily Prednisone (fixes calcium in the blood to the bones, so I understand).
Anyway, would have to conclude that docetaxel is partially working. Am doing two more sessions and then will see what goes. Normally the docs concentrate on the effects the meds have on PSA. In my case the doc had said nothing prior to the blood test about ALP. Maybe they grasp at straws? Anything to show that something positive is happening. My take is that if PSA does not react in a positive fashion the treatment ain't workin' right!
I am in Canberra, in Australian Capital Territory.
It is a beautiful small inland city that gets cold in winter.
Many ppl don't like the Australian Parliament being here, the stench of BS peaves them muchly, but I am immune to such things and see past the minor problematicals of existance.
I came here at 26, and settled in, and I met many who could not stay, then they'd leave, then get regrets about leaving.
Alk phosphate is a good indication (apart from a bone scan which is sovereign) as to how the cancer is spreading into the bones. Normal (non-cancerous person is 40 - 120). Note that you can have a reading well within this range (as I do) and still have metastatic to the bones (as I do).
Well, I have countless bone mets. There are maybe thousands more, all presently too small to be seen in a scan. Nobody has mentioned that I have abnormal blood test results apart from the dreadful Psa number that relentlessly tries to go up.
I rode a good 254km this last week, no pain yet, and I have just quit abiraternoe because it stopped working. I think it caused irregular heart rate which may now settle back to more normal and my averqage speed on bike might go up a bit, and even if I have to begin getting docetaxel. It seems a man can have a lotta cancer before pulling him right down.
My docs like seeing me arrive to talk to them, dressed in winter lycra. Cold here now in Canberra, mid winter. All the other 71 yo blokes are never to be seen on bicycles, and the number of ladies cycling, young and old, is almost zero.
If you are Stegosauarus, maybe I could be Cyclosaurus, a kind of wierd and almost extinct creature found on Earth and who people used to say, there 'ee goes, th man they could not root, shoot, or electrocute.
Ya gotta do wot ya wanna until ya canna do it, IMHO 
Patrick Turner.
The Stegosaurus is a long story. When my wife and I were dating, she arranged a picnic lunch on Angel Island in San Francisco Bay. The only theme picnic plates/napkins she could find were stegosaurus ones. So it became quite an icon - we had plastic toy stegosauruses on our wedding cake instead of the usual man and woman. Would be interested to know the origin of some of the other "handles" people use. "Tall_Allen" seems obvious but "Nalakrats" is a puzzler.
Good old Stego, probably less threatening than Velo, short for velocaraptor, a terrible animal to ever meet down a dark alley.
Old Tyran was another grandly unplesant animal. Had terrible stinky breath. Bronto only suits wedding cakes for ppl whose BMI is 100.
I forgot what was on my wedding cake in 1976. The Dear Wife vammosed after 18 months, no fowarding address, so then all my romantic talks to sheilas all began with "Now Darling, can you explain why I should chase after you?" Usually no reason was findable by anyone, so I never got around to breeding, and I figure I did the planet a lot of good, and the kids of other blokes did not have to compete with mine at house auctions.
Pca made me abandon all ways of thinking and feeling I had before I turned 50.
I now remember every other day to cycle about 70km. I'll marry the bicycle soon, because I can go for a pharkin ride any old time I pharkin like. I refuse to be completely serious while sitting on Puff The Magic Prostate Grenade every day, and now likely to explode, blasting me to the nothing that is something in the Cosmos.
Patrick Turner.
Hi Bruce. Idiosyncracies of the English language. Inserting quotation marks around the word plummeted was meant to imply that the PSA really did not plummet ...implying that plummet was certainly an exaggeration.... as one would probably expect from 3 sessions of Docetaxel; all that was achieved was a minimal decline! Hope that clears thing up!
Cancer spread to lungs and lymph nodes 
Could exercise prevent prostate cancer spreading to the bones?
Prostate cancer spread to lymph nodes 
If cancer has spread beyond the prostate, is RP best first treatment option?
