Have you talked about getting a biospy? If you aren't responding to treatment, I would be trying to figure out why. You could do molecular testing for somatic gene mutations and also see if there is Neuroendocrine Differentiation. This might help you direct your treatment to something that would give you a better response. Something to discuss with your doctor.
Did they take a tissue sample or was it a "liquid biospy"? You can tell gene mutations with a circulating tumor cells (blood test), but to see neuroendocrine cells you need a tissue sample.
What mutation?? There are some immunotherapy drugs in trials in other cancers and proof that there is potential to treat based on mutation and not cancer type...
You will only really know where you are several weeks after the last chemo. The PSA typically goes down after the chemo for about 3 to 4 weeks, and then starts rapidly climbing again as the immune system starts to kill cancer cells once again (chemo trashes the immune system which is why you get false low PSA readings for a while). It is where that climb levels off - if it keeps going, you are one of the unlucky ones where chemo did more harm than good. If it stays low, that would be a success. That said, I see the odd person reports raised PSA soon after chemo, and that then declines and stays low. Perhaps they have a cast-iron immune system! Everyone is different!
My husband's PSA rose after the second chemo. I looked it up and it seems only about 20% of people have this happen. There was no tie to outcomes (it wasn't better to have it go up).
If it's still rising after four, they'll move on to something else. Four seems to be the magic number of required rounds to know if the PSA is a blip or a failure.
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