Rapid PSA, Failed Treatment.

[GoEZ]

I just got another kick in the stomach. I have be on Zytiga for just over 2 months. During the 2 week blood test to check my liver I asked for a PSA test. They were as followed: 8(started here), 7.32, 7.92, 10.76. That last jump was almost 3 points in 2 weeks. The VA called the day after my blood test and ordered a bone scan ASAP. Has anyone seen jumps go up that fast? I have had Lupron (7.5 yrs) Bicalutamide (1yr), Enzalutamide (2yrs), and Zytiga (2 months). It is the nature of my cancer to have a rapid PSA rise once a treatment has failed, however this is the fastest rise in my PSA. Just wondering ( going a little crazy) if anyone has seen this happened to them. Bones Scan, Lupron shot, PSA test and Doctor visit this coming week.

[Tall_Allen]

After enzalutamide fails, Zytiga doesn't work for very long. This is expected. This may be a good opportunity to try Xofigo for bone mets. You also have not yet had chemo. Sometimes chemo resensitizes the cancer to Zytiga or Xtandi. Provenge is also a possibility.

[GoEZ in reply to Tall_Allen]

How often does that happen with chemo? That would be great. As for Chemo, how bad is it? Do Mets cause pain? I feel nothing other than the side effects from the Meds. I wasn't aware that Zitiga failed so quickly. I have been feeling so good since i started Zitiga, the best that I have felt for years. Any advice on Chemo? This day just came too soon.

[Tall_Allen in reply to GoEZ]

We don't have good data - I'd guess about a third of the time.

Why don't you put docetaxel in the search bar to see how others experienced it.

Bone mets will eventually cause pain - chemo, ADT and radiation are palliative.

[GoEZ in reply to Tall_Allen]

Thanks for the information.

[AlanMeyer in reply to GoEZ]

My sense of the postings I've seen here is that the response to docetaxel is highly variable from person to person. Tall_Allen's excellent summary of options for newly diagnosed men (obviously not your situation) discussed the side effect rates for chemo and Zytiga in the CHAARTED and STAMPEDE citing statistics showing that about 60% of men getting the chemo along with ADT had some nasty side effects (grade 3-5). But that still leaves 40% whose side effects weren't that terrible (grade 1-2). Furthermore, I think that side effects can be lower if you get the chemo from an oncologist who is very sensitive to the issue and uses the right drugs and procedures to minimize neutropenia, nausea, and other side effects. I haven't had chemo but I once was given an anti-nausea drug that was generally used for chemo. I was amazed at how effective it was. My nausea and vomiting stopped immediately and I felt much better.

Here's Allen's summary: pcnrv.blogspot.com/2017/06/...

He may have other postings that are also relevant.

I think you should get chemo and not wait for things to get much worse before you do. All the drugs seem to work best when the disease burden they have to treat isn't too huge.

You may also want to look into apalutamide (trade name Erleada) and Lu-177. The Lu-177 treatment success can be predicted by a Gallium-68 PSMA PET scan. If your PSMA level is high (the higher the better) the treatment can be very effective. If it's low, you can avoid the cost and side effects of the treatment because it won't help or won't help much.

Best of luck.

Alan

[GoEZ in reply to AlanMeyer]

Thanks for the information.

[GoEZ in reply to GoEZ]

I have a doctor app this week. I'm sure he will recommend that i should get chemo. I've always knew this day was coming, it still stings when it arrives. I will check into your advice. Thanks

[vandy69 in reply to GoEZ]

Hi GoEZ,

Been in this battle for 6 years (see bio for complete treatment history).

Chemo with Docetaxel/Carboplatin was not that bad, since my MO managed SEs. Had a infusion of Aloxi preceding each chemo to prevent nausea and it worked. Took Dexamethasone day before, day of, and day after chemos to moderate SEs.

Took daily oral 100mg B6 to help prevent peripheral neuropathy and I also iced my hands and feet. Left infusion center with On Body Injector of Neulasta to boost white blood cells. Used Biotene products for mouth care.

You and your MO can work to minimize the Side Effects. You will get fatigue as cycles progress, but Google Mayo Clinic and Wisconsin American ginseng to see their trial results.

Best wishes. Never Give In.

Mark, Atlanta

[Hidden in reply to GoEZ]

I understand your mindset. I too fear that call “Chemo” .Youre not alone. I haven’t done it yet either.If that is your treatment ? It just might be the thing to extend your stay in this grand hotel. 😉 Hopefully it’ll help you .That’ll give me less fear of my future..Heal yourself any way that you see fit. Expect a great response and live healthy ..

[Hidden in reply to AlanMeyer]

Excellent advice..

[GoEZ in reply to Hidden]

Thanks

[Hidden in reply to GoEZ]

You will do whatever it takes to put APC on its ass. Good luck brother..

[Gary94]

Xtandi failed for me after taking it for less than a month. All the others failed (casodex, zytiga). I've been on chemo once every three weeks. Started with docetaxel for 8 treatments then switched to cabazitaxel. Took me off that one and now Xofigo is next. Psa hasn't been rising that much though. Fluctuating between 13 and 8. The chemo seems to be holding the psa in check at this level.

[GoEZ in reply to Gary94]

Thanks

[RangerTug]

I have been on Zytiga since September 2017. PSA then was 26 in March 2018 it was 55 scans showed no change in the Mets, oncologist said to hang in , he was more looking at the scan results, May 2018 PSA was 44 and September 2018 down to 24 plus new scans again showed no increase, if anything there was some reduction in my Mets. I still have my quarterly Zoladex injection.

So don’t give up yet you may be slow in responding like me, I am hoping that I will get a few years from the Zytiga.

Good luck

[Hidden in reply to RangerTug]

I hope that you get many years of happiness...

[GoEZ]

Thanks

[Je1234]

My dad was on zytiga for 2 weeks in January 2019, then got pneumonia. He was admitted into the hospital they tested his psa when he was admitted it had gone from 166 (original at dx November 25, 2018) to over 550. The doctors stopped zytiga until his infection was cleared. We begged the dr to let dad try zytiga again because we didn’t think he had had enough time for it to work. The dr agreed and almost 2 weeks later February 7 2019 - February 18 2019 his psa dropped to 370. The doctor was not expecting this and agreed to continue zytiga and check the psa again. I don’t think that anyone knows how the medication will respond and sometimes we just have to push for the dr to keep moving forward.