PSA rising

[beatPC]

PSA test this week 4.8 up from 1.86 in three months. On Lupron, Enzalutamide. What is next best option for me? Any experience with immunotherapy would be helpful. Thanks.

[GP24]

Immunotherapy is done in clinical trials only. These did not show convincing results for prostate cancer yet.

I would suspect that the proton beam radiation therapy did not include the seminal vesicles. The cancer which remained may be causing the PSA rise.

[beatPC in reply to GP24]

the seminal vesicles were removed during my prostatectomy. the cancer had spread to them.

[NPfisherman]

There is a trial of adding indomethacin to enzalutamide to break resistance...you may try that, and consider what GP24 said..good luck...

Fish

[beatPC in reply to NPfisherman]

thanks

[Magnus1964]

If you have radiologically detectable disease you might be eligible for Provenge.

[beatPC in reply to Magnus1964]

git it

[tango65]

You could discuss the possibility of getting a PSMA PET/CT or an Axumin PET/CT to determine if there are metastases. If there are metastases perhaps it could be possible to do direct treatment with SABRT.

There clinical trials for SABRT:

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

Since your PSA is going up being in ADT + enzalutamide your could discuss Provenge.

There are clinical trials with enzalutamide or abiraterone and niclosamide in people failing these medications:

clinicaltrials.gov/ct2/resu...

Niclosamide could revert the cancer resistance to these meds.

This is a list of prostate cancer and immunotherapy trials in the USA:

clinicaltrials.gov/ct2/resu...

There are other possible treatments such as chemo, abiraterone, Lu 177/Ac 225 PSMA, Xofigo etc.

[beatPC in reply to tango65]

thanks fir the links. i’ll follow up.

[beatPC]

seems i misheard. psa actually 4.18. i’ll take it.

[j-o-h-n]

Can you please provide "a little more about you"? Age, Location, Treatment center, Doctor(s) names(s). All info VOLUNTARY. If you wish to respond please do so in a future post and NOT to me. Your info helps us help you and also helps us. Thank you.

My advice "get a second/another opinion from a recommended oncologist ".

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 04/09/2019 7:38 PM DST (Uncle Sam's Birthday)

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

seeing another oncologist on Friday

[beatPC in reply to beatPC]

recent ct scan revealed tumor 4.7 cm x 3.3 cm behind pelvis. my oncologist is scheduling mri to get a better look. bone scan shows some activity that is inconclusive in lower spine (had an injury there as a boy and recently fell on my tailbone which might have something to do with it but that’s my speculation). meeting with onco in two weeks to discuss. so far we’re looking at something that works differently from enzalutamide or in addition. could be apalutamide + immunotherapy trial or prostar trial. would be great to hear from anyone who has experience with either of these trials. onco says radiation may not be an option, but that is being explored. given my age (62) he didn’t think heavy chemo is a good option at this time.

[j-o-h-n]

I posted this many times. Besides my Pca I also have a melanoma in my lungs. Fighting it with the IMMUNOTHERAPY drug Keytruda and it's working. Just mentioned this because of the immunotherapy approach to treating cancer. May not be applicable to you (or to Pca right now) but at least you know some immunotherapy drugs are working.

I'm glad you're seeing another oncologist on Friday.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 04/24/2019 6:44 PM DST

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

Thanks