On Lupron and chemo and PSA went from .28 to .48 in two weeks

[Wyldhare22]

My husband started ADT in January with Firmagon, two months in a row. His PSA dropped from 9.79 to .69 in that time. In March they switched to a six month Lupron injection, which brought it down to .28.

Two weeks ago, he started chemo, and yesterday he had a follow up and now his PSA is .48! Is this normal? He is being told chemo can make PSA go up, but I have not seen that mentioned before.

I am really freaking out! Any advice or information would be appreciated! His next chemo is a scheduled for a week from tomorrow.

[Hidden]

It's a small increase so I do think it could easily be from the chemo. I know it's hard, we watch these numbers closely but we have to keep our eyes on the big picture. My doctor reminds me that we are treating the cancer and not the PSA.

It sounds like he has gotten a good response so far and I think you need to look at the overall progress. It looks like he is doing optional early chemotherapy like I did to get a survival advantage. This is a good plan.

The important thing is that he is doing the right things to give the best chances of long term survival and he has had a good response so far. Also keep in mind that .48 is a very low PSA. Wishing for his continued success with treatments. Hang in there, we are with you in this fight.

[FCoffey]

Disturbing the tumor in any way can cause PSA to jump. It's rare that you need to worry about a single reading, the long-term trend is more important. His PSA trend is down, way down. the most recent reading is only 5% of the original one.That's a great response.

His PSA will probably return to baseline, or perhaps below, in the months ahead.

It's easy to say, but try not to worry. This is a long haul, hopefully many years. You don't want to wear yourself out for every little bump.

Good luck to you both!

[Tall_Allen]

It's very common that PSA increases immediately after chemo (or radiation, orany cytotoxic therapy). In fact, it's a sign the therapy is working. The reason is because chemo kills cancer cells. The dead cancer cells dump their PSA into the serum, increasing the detected PSA temporarily. For this reason, it's a good idea not to get a PSA test so soon - it only causes anxiety and doesn't provide any useful information.

[Wyldhare22 in reply to Tall_Allen]

Thank you, that makes sense and reassured me.

[Hidden]

With all medication his PSA is still undetectable! By this I mean less than 0.1. Written <0.1. If you are going to worry, stop using the sensitive testing format. Fourteen years ago I asked my research medical oncologist about using the sensitive PSA test. His response was, “Do you want to worry when it fluctuates?” Further than in the hands of most people, the results are meaningless. The important values are measured in tenths, not hundredths or thousandths. All of this from a guy in academia and one who researches genitourological cancers. You might asks your doctor on what value he places on a PSA test measured in hundredths? And, this affects his treatment decision.

BTW, I had monthly PSA for the first eighteen months of metastatic PCa (plus the prior eight month period 90 days after the completion of radiation) then every 90 days I’m easing to every 120 days, yep, over a hundred PSA and T testings. Frankly, I have been worry free since 2005.

In my case, my PSA fluctuated from 0.1 to 1.0 for nine months after the completion of a six month chemotherapy-hormone therapy trial. However, I was assured that cancer cellular apoptosis was continuing to take place with the damaged cells......

Final point, the antigen used to measure PSA comes also comes from other organs of the body in minute quantities that can be measured in hundredth or thousands. Totally not related to the prostate. Do you know that women can and do get a reading of measurable PSA?

Let your guy do his magic and kill the little bastards and stop worrying until PSA rises three times from 0.1. At 2.0, I would be real concerned, May your husband have many undetectables.

Gourd Dancer

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[tom67inMA]

Despite all the advice to not freak out, I do encourage you to come here and post if you are freaking out about something. We'll most likely tell you not to freak out :-), but I do believe there's therapeutic value in getting your worries out.

[Wyldhare22]

Thank you, I appreciate that!