Hi,
Stage4 PSA 800 Gleason 9 4+5 dx with spine and bone mets in July 18. On ADT immediately and chemo Sept to Dec. PSA in Mar was 0.2 with a good CT scan.
Results today had PSA at 5, so am a bit in shock. Has anyone had such a steep rise in their PSA results? Any causes other than the obvious?!
That’s indeed surprising...has anyone talked to you about abiraterone Enzalutamide apilutamide or any of the other 2nd line hormone blockers?
Something needs to be done!
How extensive were those bone mets? How many places?
Gleason 9 can be tough..I'm a 11 year survivor..My PSA is now over 1000 and if I let it, it would double every 5 weeks..Doubling time is more important than the actual number. Have you tried Zytiga (abiraterone acetate) ? It controlled my cancer for 2 years..Chemo (Cabazitazel) worked pretty good but once I stopped taking it my PSA exploded upward..There is a limit (for me anyway) as to how much chemo you can do...At the moment I'm trying to get into a trial that uses Lu-177 / PSMA-617. Failing that, maybe R-223 ..But, lets face it, terminal cancer is terminal cancer and sooner or later I'll have to face that reality and deal with it..
Fairwind,
What do you think about trying this:
You are probably beginning to become castrate resistant. The same rapid increase happened to me at about the same point. My doctor told me that in his experience, guys who do early chemo often have a rapid increase in PSA when castrate resistance starts. The good news is there are second line ADT agents (Zytiga and Xtandi) and both of those can take your PSA right back down to very low levels. The response rate for both of those is excellent. I started taking Zytiga when my PSA went up to around 26. It went to undetectable in around 2 months.
I'm coming up on a year on Zytiga. PSA at last check was undetectable.
Before doing anything you should get the PSA measure again. If you had only ADT and chemo you should discuss adding abiraterone or enzalutamide ASAP. If your testosterone is below 50, and the PSA is progressing your cancer is castration resistant. You could qualify for Provenge and for Xofigo since you have bone metastases.
Yes, the result struck the team as rather anomalous so have asked for urinary tests and subsequent to that another blood test.
Best of luck!! There are many treatment optons available for the the treatment of your PC.
Confirm that PSA. If confirmed, I think you should discuss Xofigo as a next step (before Zytiga). Consider starting Provenge at the same time.
Is this based on two tests?
You should probably start taking weekly tests to get a better track of your doubling rate.
Can you tell where you're being treated? and your location? Voluntary info.
Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 06/20/2019 5:23 PM DST
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