My PSA is starting to rise progressively in the last 4 readings (0.17, 0.19, 0.26, 0.45 and the last in 0.73,). My treatment is Zytiga. Some advice to try to stop this progression, before having to break the treatment. Thank you
In 4 months of PSA from 0.17 to 0.73 - Advanced Prostate...
In 4 months of PSA from 0.17 to 0.73
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joancarles
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I would be interested in knowing the exact time span in which these 5 readings (not 4) were taken. 30/45/60/75 days or more or less ?
the readings are: August 0.17, September 0.19, October 0.26, November 0.45 and December 0.73. Approximately every 28 days
Well, the time duration and readings clearly indicate that your PSA has more than doubled from 0.17 in August to 0.45 in November (3 months or less). Not a good sign at all. Further, from your reading of 0.19 in September your PSA has more than trebled to 0.73 in December.
As to what to do, I think Tall_Allen would be the right person to advice. I am still a learner on these matters.
Thanks whatsinaname
dude everyone has tryed something at least 1x and in some its worked and others it hasn't. u need faith in your oncologist or urologist if not change if not satisfied. don't waste the time and decision to change over long periods of time. u are control of your body your the one who is going to die from this disease not the doctors.
IMO, I don't think that you repeatedly telling folks on this forum that they are "going to die from PCa" is helping them in any way! Afterall, we are here to share ideas on how to deal with this disease and hopefully survive long enough to die of what is considered 'natural causes'. I know many men who have lived 'full lives' with PCa even when treatments were in their infancy.
will dude lets be honest here on this site. first u WILL die from this disease or u will die from something else as we get older. there are so many fresh fish with all kinds of ideas from their urologist or oncologist some are good docs and others are dumbys. i've had 10 years with less issues then others but i totally believe in truth. remember some of these treatments aren't done in usa, some aren't offered in the area where u live. if they read everyone on this site they will get the good and bad advice and the docs are who they should listen to
Well dude, I'm 75, 14 years post-op, and I'm hoping to hang around for a few more years and then die quickly of a myocardial infarction brought on by a half dozen girls 'having their way' with me!
Best holiday wishes, and may you also hang around for many more years and go peacefully without experiencing pain!
thank u but u know i don't care about living longer. why u ask, will all of my love ones that i care about are dead and seeing them forever is very important. thanks for your insight we need more honest people who state what has happened and treatments that worked were for that individual not for everyone.
I'm sure you still have a lot to live for. You can always make new friends even if you have lost some family members. My family is in Chicago 10,000 miles from me, and I experience much enjoyment with the company of my new friends. Actually my friends and I spend more time together than I did with my family. When my children got married they started new lives of their own and we didn't spend much time together anymore. Most of my friends here are retired and are always available for lunch/dinner, etc. I am never alone.
i've had it for 10 years and as u or your friend u haven't broke 2.0 the normal range is 0-4.0 u could even have a enlarged prostrate what i would do is relax have a psa test until it reaches 4.0 or higher. remember all the drugs out there will stop working your body will rebuke them so don't weaar out your options to early
The PSA readings are miniscule and the envy of many. However, at your young age I would share your concern and want to be looking ahead for my next treatment option.
Reading your history, is it correct that the only treatment you have had is ADT and Zytiga w/prednisone?
Would you be in a position to consider an advanced type of scan like Axumin or better yet PSMA as I am thinking of the bone directed treatments like Radium 225. Do you have any symptoms? You had an amazing drop in PSA from Zytiga.
It is my first treatment after diagnosis 16 months ago.
If you follow the PSA progression, my MO wants TAC in January.
Sorry what is TAC please?
TAC is PSMA.
At this time I do not have any symptoms.
Since the beginning I have had little pain. since the beginning of the treatment I have not had to take any medication for pain.
Absolutely the same here. Hardly any pain but PSA not falling and treatments moving from casodex to eligard to radiation and now to chemo (deocetaxel).
Lets see how it goes 
Cheers and all the very best.
PCa doesn’t cause pain until it gets to bones and even then not til it gets bad. Radiation and xgeva can keep it from getting to that point.
what is tac? and i would believe a lot of guys have no pain or know they have anything wrong. i've been battling it for 10 years and no pain or anything, don't know if that's good ,i'm lucky or what.
You can talk to your oncologist about switching from prednisone to dexamethasone. How many metastases do you have and where are they?
My starting PSA was 1350 with multiple bone metastases and two ageandados, not very significant.
Then you are a good candidate for docetaxel. If you used a bone scan/CT before, that's what you should use now - otherwise you won't have a comparison. TAC is unnecessary and will not provide usable information.
I'm afraid that the Quimio is my next step. Thank you
1350..holy cow you need the Quimo
Ride zytiga on way up as long as you can. Psa is not important, but symptoms and scan are. You next pill should be xtandi. They might say it is cross resistant but I would try. I rode it until the psa was 950 after almost 3 years. When scan showed progression ,I switched to xtandi. Scan showed marked improvement and psa went to 5. Have been on xtandi for one and a half years and only now is starting to fail. Have not had any pain for close to nine years.
Dr,
why is PSA not important...were you on Lupron + Zytiga on way to PSA 950 and are you now on Lupron + Xtandi...was your Doc in on the decision to let it ride to 950 and how extensive was was the progression...what do you define as failure on Xtandi
Gus
I think it's the line that my MO wants to follow. If there is no progression we do not change the treatment.
It seems surprising that you arrived at a 950 PSA without progression in any part.
i tryed xtandi but i felt it wasn't moving fast enough for me so i dropped it after a few wks and went to zytiga. i would go thru the basic routine of all of them when u let it run the course say psa 15 at each change of new drug when u did all that then zytiga lupron/eliguard shots and finally provenge treatment. there are treatments out there in europe so if u have the $$$ to travel over seas go for it. or find a state that has the drug or treatment ctr then travel for it. not all states have the same treatments to try or available to even try
charlie
On the original trials, you needed three things to stop the trial, psa three successive rises, scan progression and symptoms. They did not take you out of trial just for psa progression. If you felt good and scans showed no progression of mets, you stayed on trial. Some people make a lot of psa and some make a little psa ,which is a sign of neuroendocrine mutation.
u realize that a psa of .0-4.0 is normal anything above it could be cancer thats why the biopsy that will tell u psa's don't. i would say u don't have it because it hasn't really moved much your still below the average of normal. i would hit it hard or have it removed now maybe then your cured. once its remove then the blue pill for sex
charlie
You don't seem to realize that the so called "NORMAL" range of 0-4 PSA is for men never DX with PCa. Once A man has been Dx with PCa the 0-4 range goes out the window.
My PSA is less than 1.0 and I have visible lymph node Mets in my pelvis and abdomen. I wish you would stop dishing out this erroneous advice.
I went on ADT3 and had all my pelvic lymph nodes hit with IMRT back in 2015 ( total 75 grays) when mri found two suspicious iliac nodes. No recurrence in lymph nodes since.
I hope this helps in clearing up some controversy among us.
From the **THE AMERICAN CANCER SOCIETY'S WEBSITE**
Tests for Prostate Cancer
Most prostate cancers are first found during screening with a prostate-specific antigen (PSA) blood test or a digital rectal exam (DRE). (See Prostate Cancer Prevention and Early Detection.) Early prostate cancers usually don’t cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If cancer is suspected based on results of screening tests or symptoms, tests will be needed to confirm the diagnosis. The actual diagnosis of prostate cancer can only be made with a prostate biopsy.
Medical history and physical exam
If your doctor suspects you might have prostate cancer, he or she will ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.
Your doctor will also examine you. This might include a digital rectal exam (DRE), during which the doctor’s gloved, lubricated finger is inserted into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if it’s only on one side of the prostate, if it’s on both sides, or if it’s likely to have spread beyond the prostate to nearby tissues.
Your doctor may also examine other areas of your body. He or she might then order some tests.
PSA blood test
The prostate-specific antigen (PSA) blood test is used mainly to screen for prostate cancer in men without symptoms (see Prostate Cancer Prevention and Early Detection). It’s also one of the first tests done in men who have symptoms that might be caused by prostate cancer.
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Most men without prostate cancer have PSA levels under 4 nanograms per milliliter (ng/mL) of blood. The chance of having prostate cancer goes up as the PSA level goes up.
When prostate cancer develops, the PSA level usually goes above 4. Still, a level below 4 does not guarantee that a man doesn’t have cancer. About 15% of men with a PSA below 4 will have prostate cancer on a biopsy.
Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.
When considering whether to do a prostate biopsy to look for cancer, not all doctors use the same PSA cutoff point. Some may advise it if the PSA is 4 or higher, while others might recommend it starting at a lower level, such as 2.5 or 3. Other factors, such as your age, race, and family history, may affect this decision.
The PSA test can also be useful if you have already been diagnosed with prostate cancer.
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In men just diagnosed with prostate cancer, the PSA test can be used together with physical exam results and tumor grade (determined on the biopsy, described further on) to help decide if other tests (such as CT scans or bone scans) are needed.
The PSA test is a part of staging (determining the stage of your cancer) and can help tell if your cancer is likely to still be confined to the prostate gland. If your PSA level is very high, your cancer is more likely to have spread beyond the prostate. This may affect your treatment options, since some forms of therapy (such as surgery and radiation) are not likely to be helpful if the cancer has spread to the lymph nodes, bones, or other organs.
PSA tests are also an important part of monitoring prostate cancer during and after treatment (see Following PSA Levels During and After Treatment).
Transrectal ultrasound (TRUS)
For this test, a small probe about the width of a finger is lubricated and placed in your rectum. The probe gives off sound waves that enter the prostate and create echoes. The probe picks up the echoes, and a computer turns them into a black and white image of the prostate.
The procedure often takes less than 10 minutes and is done in a doctor’s office or outpatient clinic. You will feel some pressure when the probe is inserted, but it is usually not painful. The area may be numbed before the procedure.
TRUS is often used to look at the prostate when a man has a high PSA level or has an abnormal DRE result. It is also used during a prostate biopsy to guide the needles into the correct area of the prostate.
TRUS is useful in other situations as well. It can be used to measure the size of the prostate gland, which can help determine the PSA density (described in Prostate Cancer Prevention and Early Detection) and may also affect which treatment options a man has. TRUS is also used as a guide during some forms of treatment such as brachytherapy (internal radiation therapy) or cryotherapy.
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 12/15/2018 11:24 PM EST
John,
you are ready for Quimo the Indian Death Bird good luck on your final destination
Do you know how American Indians get their names?
If not I'll tell you:
This young indian brave says to his father, "dear father how do indians get their names"?
Father answers: "You know son that whatever is happening when you're born that's how you get your name. Like chief Flying-eagle, when he was born an eagle was flying above his teepee. And chief Running-bear was born just as a bear was running by, but why do you ask Two-dogs-fucking"?
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 12/18/2018 6:56 PM EST
Oh Quimo.... yes a/k/a the Vanishing Bird that flies in ever decreasing circles until it flies up its own asshole and disappears. Very few are actually seen, but moving your head around and around while walking down Times Square on New Year's Eve is probably the best time to see one.
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 12/18/2018 7:17 PM EST
ther is a difference if u have mets if u show nothing is what i was commenting is relax of course u want to something if ct or bone scan shows something. if they are experienced in checking out there body then they know this they don't need to be told.
Dr. Meyers said not to worry about PCa that makes a lot of PSA and worry about PCa that makes very little PSA with Mets...you are in trouble probably neuro-endocrine PCa
The PSA range 0.0 to 4.0 is just a guideline. I was diagnosed with prostate cancer in 2011 when my PSA was 3.4. In 2016, I had a recurrence with a PSA of 1.5. Now I have metastatic cancer in lymph nodes, diagnosed when my PSA was 3.28.
I'm afraid that the Quimio is my next step. Do not hesitate if the doctor suggests chemo. Most of us only had annoying side effects. Hit it early, hit it hard. Then you may possibly re-challenge with Zytiga or try Xtandi or other treatments. Psa is only one indicator, is alk phosphate high or going up? and will you have bone progression on your scan? Things I've learned from this community. Thank you all. And if I got something wrong , someone please correct me. I vote for chemo if your dr. has even slightly suggested it.
i guess your docwants u to use your best medicine even if u haven't reached the numbers that say u have cancer. for me i would n't use any cancer meds until i was over 4.0 it could mean anything with the small rise in your psa but me i would take a drink and get tested every once a year.
charlie
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