PSA up further even after Lu-177

[whatsinaname]

I did my FIRST Lu-177 infusion on the 23rd of April, 2019. 15 days later on the 8th of May (today), I took a series of blood tests including my serum PSA. The PSA level has risen to 16.92 from 16.02 a rise of 5.62%.

So, instead of falling or remaining steady, my PSA has actually gone up

My alkaline phosphatase levels are at 87 (range 40-150) which is good. Kidney and liver tests are normal and so are my Vitamin D levels.

Will take another round of blood tests on the 22nd of May.

Any comments, anyone ?? I know I have to wait...give it time....etc, etc, etc. Any insights into WHY my bloody PSA just keeps going up ?? My next PSMA PET-CT scan is scheduled for end, July 2019 earliest after taking the second infusion.

Thank you very much for any insights.

[MichaelDD]

No in put my brother just good thoughts. On my way to UCSF in California right now for 2 weeks of review. Just got to believe! One step at a time.

[whatsinaname in reply to MichaelDD]

Thanks, Michael. I am not very good at "just believing" unfortunately

[Jbooml]

Hi Carlos....I think its been said more than once that an explosive rise in PSA after radiologic treatment is not unexpected...so your results are somewhat ambiguous....but the 'one man one cancer' caveat..as I like to call our condition, always applies. Take comfort in the great implied liver and kidney function enzyme results. Can you suggest your 'quacks' test chromogranin A levels to better understand any NEPC resolution....seems logical.

Jeff

[whatsinaname in reply to Jbooml]

Yes, I have done the chromogranin A test and it was negative for NEPC. Since my quacks were not willing to recommend that I do the test, I just got it done anyways In Bombay, we are fortunate in that respect. Thanks, Jeff !!!

[Ssiddy in reply to whatsinaname]

Hi. Does LU177 resolve NEPC. Asking as my dad has neuroendocrine differentiation and am hoping he can still have LU177. Thx

[whatsinaname in reply to Ssiddy]

Sorry, Ssiddy, I really don't know.

Since, I tested negative for NEPC, I did not ask any of the doctors I am in touch with. I tried doing a search of this forum but "Hidden" who has done Lu-177 also was not able to say categorically whether Lu-177 helped patients with NEPC.

[Jasonhousz]

The information I have is that the psa decline is generally after 6 weeks, so maybe you wait any longer?

[whatsinaname in reply to Jasonhousz]

Thanks, Jasonhousz. I do not seem to have much of a choice, do I ??

But, yes, I am quite prepared to wait for more time. In the interim, I will work on Plan B and Plan C, if this treatment fails.

Thanks again, Jasonhousz.

[cesanon]

What do your docs day?

[whatsinaname in reply to cesanon]

They will probably tell me that I should wait for at least 6 weeks, if not more, to get a correct picture. And, maybe, they will be right.

I will be calling them tomorrow. If they say something different, I will post for sure.

[whatsinaname in reply to cesanon]

As expected ALL my doctors ( I spoke to 3 of them) told me a flare up in PSA is nothing to be worried about and that the PSA test taken after 6 weeks to 8 weeks will indicate the true picture. The next infusion is scheduled for the 25th of June.

[cesanon in reply to whatsinaname]

That's what I sort of suspected. It seems like it frequently goes the wrong way before going the right way when being treated.

[whatsinaname in reply to cesanon]

Absolutely, cesanon. At least that is what everyone seems to be saying.

Thanks again and all the very best to you.

[Hidden]

I wouldn't read too much into that PSA change, especially if ALK Phos is still well within range. My doctor always tells me that we are treating the cancer, not the PSA. Once you see what's going on with the imaging, you can get a better idea what's happening with the cancer. Hoping for the best with your treatments.

[whatsinaname in reply to Hidden]

Thank you very much, Gregg57, much obliged.

[GP24]

Cells which were destroyed with radiation may release more PSA into the blood stream than other cells. Could be an explanation for your PSA result.

[whatsinaname in reply to GP24]

Thank you, GP24.

[Tall_Allen]

Most therapies that kill prostate cancer cells will increase PSA temporarily. PSA is a protein on every prostate cancer cells, so when they die, it gets released into the serum.

There is also a stimulated regrowth effect (called "repopulation") from radiation. The radiation kills the outermost layers of each tumor first. This gives the inner parts of the tumor room to grow and access to blood supply. With multiple treatments, the entire tumor is wiped out.

[savingdaddy in reply to Tall_Allen]

"Most therapies" would that include Xtandi?

[Tall_Allen in reply to savingdaddy]

Perhaps at the start. It kills sensitive cells right away and then prevents cell replication.

[savingdaddy in reply to Tall_Allen]

“At the start” How long would that be? A month, 6 months?

[Tall_Allen in reply to savingdaddy]

It can take a few months for Xtandi to lower PSA in some men. Hang in there.

[savingdaddy in reply to Tall_Allen]

Thanks Allen

[whatsinaname in reply to Tall_Allen]

Thank you, Tall_Allen.

[tango65]

You should not expect a decrease of the PSA until 6 weeks after the treatment. When I had the treatment in Germany they asked me to wait 6 weeks to measure the PSA.

[whatsinaname in reply to tango65]

Thanks, tango65.

[riichardd]

Hi.

I can't add much to whats been said above.

Just thought i'd say hi and try to give you some encouragement by wishing you all the best in your treatments going forward. You are having a shitty time with the disease even though you seem to be doing "all the right things". Lets hope you are one of the lucky people able to post in the future your PSA is down below one and all your mets have cleared up and gone away!

[whatsinaname in reply to riichardd]

Thank you very much, riicharddd. Thanks for your empathy, I truly appreciate it.

[tom67inMA]

No advice, just well wishes for you. You've been doing everything you can with a good attitude. You definitely deserve some good luck, a huge drop in PSA, and a clean scan.

[whatsinaname in reply to tom67inMA]

Thanks, Tom. I am keeping my fingers crossed

[j-o-h-n]

toes, arms, legs and eyes too...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/09/2019 11:43 AM

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

Thank you, j-o-h-n.