PSA "undetectable" but new mets? - Advanced Prostate...

Advanced Prostate Cancer

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PSA "undetectable" but new mets?

15 Replies

Hello All,

If the PSA is now "undetectable" but there are new mets... what is going on? My guy started taxatere treatment yesterday, Friday December 14th due to this new diagnosis... Has been on lupron since August 10th, and has now "stopped zytiga" due to the new treatment. Please give me some good news!!! I am so worried... MO has not given any info except to start chemo ASAP!!!

Thanks in advance!

Connie

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15 Replies
Tall_Allen profile image
Tall_Allen

Not all metastases put out very much PSA. In fact, neuroendocrine prostate cancer, for example, puts out none. Before he starts on taxotere, it is prudent to check for chromogranin A, neuron-specific enolase, and synaptophysin with a blood test. If those are elevated, adding carboplatin to his chemo cocktail may be beneficial. There are other rare kinds of prostate cancer (e.g., ductal, squamous cell, sarcoma, etc.) that also put out little PSA but may be responsive to chemo. It is a good idea to biopsy one of those recent metastases for an immunohistological analysis to determine whether he has any of the many rare types.

in reply toTall_Allen

He had a liver biopsy. From what I understood, the cancer is adenocarcinoma, same as what was found in the prostate biopsy. Does this sound correct?

Tall_Allen profile image
Tall_Allen in reply to

Yes. Sometimes even ordinary acinar adenocarcinoma puts out little PSA. If that was a recent new met, you have more assurance that docetaxel may be beneficial.

in reply toTall_Allen

His first scan was in August. No mets in liver at that time. Scan a few weeks ago showed sign of mets in liver and the pelvis lymphnodes have grown. He had to have stents put in between kidneys and bladder as one of the kidneys was inflammed. Would this kind of cancer growth show no increase in PSA? This is all so frightening!!!

Tall_Allen profile image
Tall_Allen in reply to

Everyone's cancer is unique to them in some ways. If his puts out little PSA, that's just what his type of prostate cancer does.

in reply toTall_Allen

His PSA at the end of July was 56. One week later, it was 95. He was diagnosed with advanced stage PC on August 10th. Mets to bones and lymphnodes and small spots to lung... So, he has shown signs of high psa...

NurseRatched profile image
NurseRatched

Hi Connie. Your ‘guy’ is not alone; my husband’s PCa has been this way for over a year, and he will likely be starting taxotere & carboplatin in Jan. As Tall_Allen mentioned, we recently had those tests done to rule out any mutation, and we are awaiting one last bone biopsy test result to confirm his “cocktail”. I would encourage you to ask the MO about the additional blood work.

in reply toNurseRatched

Why is your husband having to start chemo?

NurseRatched profile image
NurseRatched in reply to

Because he also has new mets with an undetectable PSA, which means his PCa is both out of remission and castrate resistant. So it’s time to pull out the big guns.

in reply toNurseRatched

Hello NurseRatched,

How is your husband doing? We are starting second round of chemo (jevtana) tomorrow, July 19th...😪

NurseRatched profile image
NurseRatched in reply to

Good luck! We are probably not far behind you. Hubs finished 6 cycles in May, and his AlkPhos is already climbing.

Please explain gene mapping... I am new to all of this... many thanks!!!!

Will the taxatere kill the cancer in the liver? I know small cell cancer requires a different kind of chemo??? Thanks in advance!

We were told the cancer in the liver is not small cell. it is adenocarcinoma. Will the taxotere take care of it?

Hazard profile image
Hazard in reply to

I had PSMA scan last year which showed 5 avid lesions in my liver. After 9 cycles of docetaxal I had another scan and no avid lesions were identified. So yes, chemo can definitely help liver mets.

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