PSA Flare Afer Initial Docetaxel

[CantChoose]

So husband's PSA went up today (5 something) after the initial chemo. Nurse says not to worry and I'm aware there's a flare associated with a subset of patients. Also aware it may be more linked to steroids than chemo.

Anyone have any thoughts on why this only occurs with some, or personal experiences as to PSA patterns during chemo? I know the studies say this isn't statistical significant with regard to outcomes, but I can't dispel the nagging disappointment and fear.

One point is not a huge jump, but I am also aware lots of you are in the under 1 range. How long did it take to get there?

[Tall_Allen]

It occurs because the chemo kills cancer cells, and they dump their PSA into the bloodstream.

[CantChoose in reply to Tall_Allen]

So maybe a high spike is actually a sign that those suckers are dying.

Good.

[LearnAll in reply to CantChoose]

yes....I concur...with TA...I read exact same thing in a reliable medical text ..that when cancer cells die en masse ...their contents (read PSA) falls in bloodstream ..giving a false reading of temporary rise in PSA.. This usually is followed with spectacular final fall

[dvcarola2]

Our MO says not to worry in case PSA goes up and down during chemo, the impt is the PSA reading after chemo. Hopefully it works well with your husband.

[Magnus1964]

PSA can flare with any new treatment. When the cancer cells die they produce PSA and you get what I call the PSA bounce.

[CantChoose in reply to Magnus1964]

I hope the ball keeps bouncing.

[Hidden]

He was on Lupron before and during chemo, right? My personal experience, and I had weekly blood draws during my six months of chemo, was a steady decrease. I only tracked the monthly numbers; but a month after I had my first Lupron in 2004, PSA reduced from 32.3 to 7.3. Started two weeks later with chemo, PSA was 3.0. The next four month, PSA was 1.0 each month. Continually dropping each month, 0.7, 0.5, 0.5, 0.4, 0.3, 0.2, etc.

I experienced a two month flare ranging from 1.6 to 1.9 on weekly PSA tests eight months later. Since then I have been undetectable.

I wish him the best in kicking this bastard.

Gourd Dancer

[CantChoose in reply to Hidden]

Yes, Lupron and Casodex both.

[Hidden]

My response to Docetaxel was that my psa was more or less low and steady for the first 2 infusions and then started going up. Start was .15 and three weeks after my last infusion it was up to 10.88. You can't absolutely say it is just a flare and that it will come down.

The so far good news for me is that the combo of Jevtana, xtandi, lupron via a clinical trail has my psa back down to 1.21 after five infusions. Don't give up hope. I am pulling for you that it is only a flare up as noted by others.