I was wondering if anyone could help me understand what is going on with my husband. He was diagnosed on June 15, 2018 with advanced, metastatic pc. His psa was 114 and went all the way down to 2.7. However, in Dec it started going up. He started Zytiga and prednisone on Dec 28 and had another blood test yesterday. His PSA is now up to 7.9, so I'm VERY upset! The doctors, etc, told me that is would most likely go down, not up! Also, he had a bone scan that showed no increase in bone mets, no lymph node or organ involvement. What could be making his PSA rise? He is currently seeing an oncologist in our area, but he also has a specialist at Duke that is weighing in on his status. Should we head straight to Duke? I'm very worried as usual, I was hoping for really good news. :-((
Zytiga and PSA: I was wondering if... - Advanced Prostate...
Zytiga and PSA
Can you clarify the treatments, many here can share their experiences and research from a patients perspective, which, of course is why you are here.
What was the treatment from 06/15/2018 to 11/15/2018?
He may be in castrate resistant state, which prostate cancer will eventually evolve to, that is, no longer responding to androgen hormone therapy (ADT). There's meds that are used to treat castrate resistance state, all here will advise getting care from cancer excellence institutions, Duke is one of these.
Yes, he has had radiation and formalin shots. He took cocetrax. (Sp?) until 12/28 when he started Zytiga.
Cocetrax? do mean Casodex?
Yes. Sorry.
Oh my, please no apologies, the meds names are crazy for us patients. So, in my honest opinion, (IMHO) get a second opinion at Duke, you need an PCa expert Oncologist.
If the PSA rises, after ADT treatments, which it has, then focus on "castrate resistance" treatment protocols, please seek Duke experts for this next phase.
a oncologist and a urlogist are about the same. they study cancer. my oncologist to me and his treatments is a maintenance doc. i'm the one who orders the ct,bone scan not this doc. he might suggest what the next treatment might go next. some of what is mentioned on this site he states we don't have it its not available. thats why i'm going for a 2nd opinion for my next treatment.
charlie
Almost all therapies (hormones, chemo, radiation) make PSA rise INITIALLY. That's because dying cancer cells dump their PSA into the bloodstream. You'll have to wait a few months to see if there's a pattern.
they should tell u with the lupron shots and zytiga there are bounces not unheard of. patience is the name of the game be patient.
charlie
I had a similar experience after two months on Zytiga, which led to me having a lung biopsy (which found mets there). After three months, however, my PSA began to go down. I was told that the Zytiga had been working so well that the number of cells dying and dumping their PSA into my bloodstream had caused the bounce. My PSA levels have now fallen steadily but slowly for the past 10 months. My doc is happy with that, and so, therefore, am I. I hope that is the case with your husband.
I have been on Zytiga+Dexmethsone since 22/9/2017 at that time my PSA was 13 by June 2018 PSA was up to 52 before it started to decrease and in December 2018 was down to 18. I have had numerous CT and Bone scans which have shown no increase with some small decrease at times. I was diagnosed in July 2010 with a PSA of 200 and retested 7 days later wiath a reading of 254. My Gleeson was 9 (5+4 for 6/12 samples 4+4 for 5 samples and 1 negative).
I have been on MDV3100, had 8 sessions of Chemo and my PSA has fluctuated up and down since 2010.
My oncologist places more emphasis on the scan results that the PSA. I think us patients place more emphasis on the PSA because it is a number we can easily relate to low/very low is good while we think high/higher is not good.
Best wishes
We are in New Bern moving here from RI in Nov 2016. I saw a local MO for a year and became frustrated as my PSA started rising from 0.08 when we moved to 159 when I had my first meeting with Dan George at Duke. Now a year on Zytiga and I am down to 14 but more importantly my mets are the same or a little less than a year ago. Dr George is very happy with that and so am I.
Go to Duke it may be a full day trip but it is worth it...get lunch at the Mad Hatter Cafe and make the best of it!
Thank you!
When this happened to my dad the oncologist said he was becoming adt resistance,in other words the cancer was becoming resistant to the treatments. So went to another form of treatment to try to keep the PSA down or keep him comfortable as long as possible. 🙏🙏🙏😡
My dad's PSA went up and down over the first 6 months he was on Zytiga. The oncologist said that such variations happen initially, the point is to wait and look at the long-term movement of the PSA, so don't stress, give it at least two more months to work.
Arthur
Thank you. I will!
If you have bone nets, you have lymph nodes. Goes there first.
Zytiga starting to fail, PSA rising rapidly - next steps?
Psa 
Psa
Mets after 2yrs and .01 PSA? New cancer?
