My dad was diagnosed with advanced prostate cancer in May 2016. He is currently on Zytiga since Aug 2017.
He had few months ago spot radiation on some of his bone mets and he had a very good response. Bone mets were reduced, PSA dropped from 2.8 to 0.7 and stable up to now. But the MRI from early this week shows that cancer spread to Liver. Doc recommended 3 cycles of Jevtana at first. And he said he is not taking PSA as a reference anymore, since it spread with stable PSA. Any one had such experience in the group? What could you recommend?
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Shumaf
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Since you father has had bone mets, bone alkaline phosphatase may be a better marker as the disease progresses. Also radiographic evidence becomes more important. PC may sometimes put out less PSA as it progresses.
Yes, I had this experience with my husband. His PPSA was very low when his cancer spread into the liver. The reason why PSA is no longer an indicator then is because the cancer has changed and most likely become an endocrine tumor. My husband was put on Carbo Platin for six and then again four cycles. Generally speaking, because the liver is such an important organ, it is a very serious diagnosis. Good luck with the treatment. Keep us posted please. Mel.
I have been in this battle for almost six years (please see bio for complete treatment history).
When diagnosed with liver mets in 9/17, began chemo with Docetaxel/Carboplatin for 6 cycles.
PSA dropped from 10.8 to .4 and liver lesions became smaller and less distinct. Better outcome was that chemo reset cancer cells and/or AR7- Splice Variant and rechallenge with Xtandi (which failed after 12 months in 2015-16) is worked again. God's miracle with Xtandi has kept PSA stable at .7 for 3 months!
I hope you will have wonderful results from your next MRI and blood work.
Do you know how the docs decides which chemo drug to go with?
My dad has already had as first line Docetaxel treatment. Now the Doc says, Jevtana (no carboplatin). Is this kind of a standard treatment for second line? I read that many people had a combo of Carboplatin with Jevtana or Docetaxel for Liver mets. I'm wondering what is the decision criteria of Carboplatin; side effects, efficiency, other mets?
Hi sharif ask if it’s possible to do a liver biopsy to check whether the cancer has changed to become neuroendocrine. Carboplatin seems to be one of the common modalities used for neuroendocrine cancer - often combined with jevtana. also now they are using lutetium 177 octreotate for NE cancer so you could check that out as well.
The Doc said that he considers Carboplatin and Lutetium 177 as backup plan. He thinks that Jevtana alone would work now. I hope it works very well. It will start in 2 weeks.
Bringing up an old post so I can keep track of it easier- I'm on Lupron/Zytiga, finished Provenge and SBRT to 4 bone mets with an undetectable PSA for around 5 months now. In speaking with my MO he wants to go with Jevtana next (trying to skip over Taxotere due to existing neuropathy). I let him know that I'm feeling pain in my ribs similar to before the SBRT, but he said that he's never seen PCa advancement with such a low PSA. I guess I need to do a little more research on neuroendocrine cancer if the pain worsens, and bring it up during our next meeting.
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