PSA stable but Cancer spread to liver - Advanced Prostate...

Advanced Prostate Cancer

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PSA stable but Cancer spread to liver

Shumaf profile image
11 Replies

Hello all,

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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11 Replies
Tall_Allen profile image
Tall_Allen

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.

Shumaf profile image
Shumaf in reply to Tall_Allen

Thank Allen, I wrote down. I ll ask about the bone alkaline ohosphatase.

MelaniePaul profile image
MelaniePaul

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.

Shumaf profile image
Shumaf

Thank you Nalakrats! I am gonna ask about the Neuroendrocrine cells.

And if this is the case, what would be the best medication/therapy? Any ideas other than Jevtana? Or is the the best way to go.

Shumaf profile image
Shumaf

Thank you Melanie. Yes, I did not like it all when I heard about the liver involvement.

I also hope the treatment will work perfectly.

vandy69 profile image
vandy69

Good Friday Morning Shumaf,

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!

Have liver MRI and blood work next week 🙏

Best wishes. Never Give In.

Mark, Atlanta

Shumaf profile image
Shumaf

Good morning Mark,

Thank you for your message. This is encouraging.

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?

Best wishes!

tango65 profile image
tango65

Talk with your doctor about embolization with SIR micro-spheres.

verywellhealth.com/sir-sphe...

sirtex.com/us/patients/abou...

Kat95 profile image
Kat95

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.

Shumaf profile image
Shumaf in reply to Kat95

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.

V10fanatic profile image
V10fanatic

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.

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

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