Is my PSA score of 2.33 good, OK or bad ?

[whatsinaname]

My previous PSA score 7 months back was 16.51. I was given Casodex 50 mg for 14 days, then Eligard 22.5 mg for 3 months and a further Eligard 45 mg for 6 months. In the interim, I had 38 sessions of radiation (IMRT). I have oligometastatic prostate cancer with the L4 vertebrae being affected. I have been treated thus far for 5 complete months. Now, my question is :-

Is my latest PSA score of 2.33 too high ? If yes, what should be the course of action now ? Thank you in advance for your views.

[Hidden]

What have your PSA levels been between 7 months ago at 16.51 and now? Is your PSA still dropping, leveling off or rising? How long ago was the radiation?

[whatsinaname in reply to Hidden]

This was my first PSA test since the 10th of January, 2018.

It was taken yesterday the 3rd of August, 2018.

The radiation was done between the 20th of March, 2018 and the 11th of May, 2018, a total of 38 fractions.

I was asked not to do any PSA tests in between as they would not serve any real purpose. Around 3 months after radiation was completed was the earliest I was asked to do my PSA test. I am on Eligard 45 mg right now.

Thank you, gregg57.

[Hidden in reply to whatsinaname]

That's correct not to check your PSA during or right after radiation. 2.33 is a big improvement from 16.51 and also it's fairly low. I think you could just check it again in a month and see where it's going. It might still be going down, possibly to a very low nadir sometime down the road. Just have to take it one day at a time. Looks good so far, hope it continues.

[whatsinaname in reply to Hidden]

Thank you very much, gregg57. Much obliged to you for taking the time and trouble to reply.

I thought the same as you did but I am a novice in these matters frankly.

I am meeting my medical oncologist on Thursday the 9th of August with

my reports. Lets see what he has to say.

Thanks again, gregg57. Cheers !!

[dadeb in reply to whatsinaname]

2.33 sure sounds good to me. Best of luck at your appt. keep us all posted.

[whatsinaname in reply to dadeb]

Thanks a ton, dadeb. Cheers !!

[Schwah]

Id ask your MO about Zytega. Zytega combined early with ADT has been shown to improve life expectancy by some 40%.

Schwah

[whatsinaname in reply to Schwah]

Yes, that's one thing for sure that I am going to bring up with him.

I am making a list of things to query him about and this Zytiga thing (abiraterone acetate) is right on top.

Thank you for the tip off, Schwah, much obliged.

[Hidden in reply to whatsinaname]

My doctor put me on Zytiga and so far it seems to be working, at least I'm feeling better. They wouldn't start me on Zytiga until I became castrate resistant. At this point, either Zytiga or Docetaxel, but not both are approved for early use with ADT. I had 2 different doctors tell me that it's an either-or thing. Although from what I've been seeing on this forum, there are some doctors that will prescribe Zytiga after chemo. Just wanted to make you aware of that.

[whatsinaname in reply to Hidden]

Thanks, gregg57.

I'll let you and the others here know what my MO has to say on Thursday, the 9th of August. This is what I expect him to say : Wait for a month. Take a PSA then. If the result is below 2.33, good. If it is a lot higher than 2.33, take a GA 68 PSMA (PET/CT) test to find out if there are any more mets (the last time only one at the L4 vertebrae). If the PSMA test is good, then wait for another 30 days and take PSA once again. I don't think he will want to put me on Abiraterone (Zytiga) just yet.

I will probably meet at least one more MO if not two, to get their opinions as well.

Eventually, the call is mine.

Many thanks, gregg57, for all the help and understanding. Cheers !!

[Schwah in reply to whatsinaname]

pcnrv.blogspot.com/2017/06/... if you are still hormone sensitive then the Stampede Ana latitude studies proved in 2017 that early use of Zytega along with adt was proven to extend life 40%.. many drs called it the biggest advance in Prostate cancer in their lifetimes. It was also proven (to their surprise that Zometa/celebrex reduced death by 22% with little side affects . The old thinking was save things for when one stopped working. The new thinking is get the bastard before he becomes too strong to beat. Get a second opinion from a center of excellence. Someone on this site will know a place nearest you.

Schwah

[whatsinaname in reply to Schwah]

Thanks very much for the link, Schwah, much obliged.

[j-o-h-n in reply to whatsinaname]

It's going in the right direction. Keep the faith.

Good Luck and Good Health.

j-o-h-n Sunday 08/05/2018 1:48 PM EDT

[whatsinaname in reply to j-o-h-n]

Thank you, j-o-h-n.