<0.1 to 0.1

[Peterd110]

I use the same place every time to do lab work. (Quest) December February and April showed psa <0.1. This month shows 0.1. Also alk phos up from 74 to 89 Hard not to worry.

[Peterd110]

Diagnosed 8/18. Gleason 9. Psa 352 alk pho’s >1000. Using zytiga, trelstar and prednisone since the start

[Peterd110]

Extensive bone Mets. No lymph no surgery or radiation

[Hidden]

What is your recent Alk Phos history? The PSA movement is very small. My Alk Phos has gone up and down during treatment. It might just be a blip, I'd check it again in a month to see if it's a trend.

[Tall_Allen]

It's too soon to give up on Zytiga. Maybe try switching from prednisone to dexamethasone:

ncbi.nlm.nih.gov/pubmed/300...

[Peterd110 in reply to Tall_Allen]

Psa 352 aug 18, 89 sept 18, 0.6 oct 18, <0.1 dec, feb, and April 19 and now 0.1. At what point should the switch from prednisone to dexamethasone take place? Since quest doesn’t test lower than 0.1, I don’t know how much the increase was.

I’ve read in other threads that quest sometimes omits the “<“. Can that be possible?

[Tall_Allen in reply to Peterd110]

You certainly have time for more tests. In that study, they called any PSA below 50 ng/ml "low." And switching when PSA was "low" was prognostic for longer effect of abiraterone.

[Peterd110 in reply to Tall_Allen]

Thanks !

[Peterd110 in reply to Tall_Allen]

Do you know why 0.5mg daily of dexamethasone is used? 1.6mg daily would be equivalent to 10mg of prednisone. ???

[Tall_Allen in reply to Peterd110]

Use this calculator:

clincalc.com/Corticosteroids/

[Peterd110 in reply to Tall_Allen]

Well I did and the dose is higher than they used in the study. ???

[Tall_Allen in reply to Peterd110]

It shows that 5 mg prednisone = 0.8 mg dexamethasone. Or 0.5 mg dexamethasone=3.2 mg prednisone, so it seems about right. 5 mg prednisone is the replacement dose for Zytiga when used for mHSPC.

[Peterd110]

Thanks for your input.

[RCOG2000]

Prostatic acid phosphatase is a marker for bone metastasis in pca that may be more stable and directly related to progress of skeletal involvement i think

[OlivertheOwl]

I had a similar issue. This is one reason to get a fine reading. <.1 could be .01 or.09 a big difference. A lab I used gave me two decimal readings. They were bought out by Labcorp who only gave me a one decimal reading. It took a lot of talking on my part to get someone who would answer me. Their regular test doesn't detect anything under.1- so meaningless. I had to convince my MD to order a different test to get me two decimal places and then three months later a second test to set a new standard and derive any meaning from the PSA reading

[Hoodad17 in reply to OlivertheOwl]

Hello, did you switch from Labcorp to another provider?

[j-o-h-n]

take another test...

Que Sera Sera

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/13/2019 9:59 PM DST