Good morning brothers, So my PSA went from 0.014 which it has been since I started ADT, but in one month it went up to 0.06. I am a ductal Adenocarcinoma patient so I am wondering if this is really a BIG jump for me....since my kind of cancer doesn't put out PSA
Thoughts.....?????
It doesn't look like a large movement for PSA, but do you have other tumor markers for your cancer that can be checked?
That is a small increase. It could be caused by inflammation. I would not worry about it. You should be looking for trends, i.e. 3 rises in a row.
You are quite right that PSA is an inferior indicator for you. Are your scans showing progression?
Yes.... they are... I am wondering if the next step is chemo and if I should start it sooner than later?
Probably a good idea - a friend with a virulent form of PC (not ductal) is responding to a mixture of cabazitaxel and carboplatin. Fatigue is his main side effect. If the platin works, it's a good indicator that a PARP inhibitor may work too.
My husband has the same kind of rare cancer that you do. He's taking Luperon and Zytiga. His PSA has gone from .9 to 5.5, so the Zytiga did not work for a year as was
predicted. He is having more scans on Tuesday and then a meeting with the MO to
see what he recommends. He had mentioned Xtandi, so that may be what will be next.
I just want the best possible treatment for him, too. If the next step is chemo for you,
please let me know what is prescribed. Keep on fighting!
How much time did he get out of Zytiga?
Only about 3 months
I'm guessing chemotherapy would be a better option than Xtandi just because the cancer is showing a lack of hormone-sensitivity.
Just my thoughts and something to discuss with his doctor.
Yes, you may be right about the chemo, and I will talk to the MO about it when we go in three weeks. I'm so afraid that his scans on Tuesday will show the cancer has spread even more. The side effects from the Zometa infusion have really hit him hard. I hope and pray that this isn't the beginning of the end. Thank you for your thoughts on his situation. I love this forum!
Linda
Sorry about your situation. Another thing to discuss with the MO is getting tested for genetic mutations that have treatments such as BRCA1, BRCA2, and ATM. These can be treated with PARP inhibitors.
He already was tested with nothing found to his benefit. Thanks for the suggestion though.
Linda
I will let you know...I should know something next week
Hi, Just wondering if your MO has prescribed chemo for you and what kind. My husband has the same kind of cancer you do, and has an appointment tomorrow to see what the next course of action is. His PSA has risen to 5.5 and we will get the findings of the scans that were done last week. Hope to hear from you.
Linda
You say your Pca does not put out Psa, but that's what its doing right now,
and it quadrupled in a month. This may be the beginning of an exponential rise of Psa that could be extremely dangerous, IMHO.
I had initial treatment of EBRT and ADT for an inoperable amount of Pca at my PG with Gleason 9 and Psa at only 8. 2 years after starting ADT, Psa was at 0.08, down from the 8 at attempted but abandoned open RP. I stopped the ADT, to see if the treatment the docs said would work actually had worked. 6 months later Psa was 8 again when there was no ADT to prevent my testosterone coming back up.
The rate of Psa increase was alarming, so I went back to ADT, Psa went down to 0.2, but slowly went up over a few years, then faster in 2016.
But if you are continuing ADT, it looks like your Pca has worked out how to ignore the ADT, and grow very well. It is what Pca does. Chemo might well be an option, sooner the better if Psa is 0.24 in another month. But maybe Cosadex, Zytiga or Xtandi might work with your ADT to slow Pca down.
I knew a man who found all these potions made no difference, and Cosadex made Psa increase speed up. So he tried 10 shots of Docetaxel, and Psa went from 40 to 2, stayed level for 3 cycles, then went right back up to 40, so then he went for DNA analysis that showed he was Brca2 positive, so PARP were used which encouraged his Psa to rise to 432 in 2 months, about the time it took to get the analysis done. A scan showed there were many new mets in his liver which made no PsMa. He did have a PsMa scan and had planned to get Lu177 but the liver mets had no PsMa avidity so Lu177 would be no use. He died 2 moths later, not yet 60, and for his wife and 2 kids it was a terrible disaster.
I've had nearly 10 years since Dx in 2009 at 62yo. But my friend got only 3 years with Pca that defied all the doctors. ADT only worked for 4 months.
He had RP, IMRT etc, but it was always soon bad news.
I would say you need the best doctors you can find.
I had 4 shots of Lu177 between last Nov and May, right after chemo failed and so far it seems to have worked with Psa moving from 25 to 0.57, trending down, and also while now taking Xtandi.
But docs said that the chemo re-sensitized my Pca to being controlled by Xtandi or Zytiga, but I have no proof of that; but doctors say things after seeing such things happen fairly often, but it is not always the case with many patients. But there is a trial in Sydney for Lu177 with Xtandi. A research doc is trying to see if that makes Lu177 work better, because she's seen it happen often.
But when my Pca begins to make Psa rise again, I might have more Lu177, or AC225 or Ra223 if only bone mets are growing again. DNA analysis has been suggested, and a range of potions could then be tried, but then my treatment will be moving to experimental without any high success rates.
My future is extremely uncertain. But at 72, I know one thing for sure, that the only certainty is uncertainty.
Today was a lovely sunny day, and I cycled 25km around a Lake here, and I felt well and happy.
So far, so good, I'll seek what docs I can get when the time comes and it will be expensive. I cannot take $$$$ with me when I begin the worry free ultimate lifestyle change to un-living.
The chemo I had 12 months ago is still affecting me, and brought down my average speed on the bike yet another couple of kph. Not to worry, I will still get benefit from whatever exercise I can do.
When you fight cancer, it means you have to urge the docs to help you, without let up. Be nice to them though, they have to deal with so many patients who don't get cured.
Patrick Turner.
Thanks for sharing about your journey and that of your friend. Do you have any theories on why he reacted so poorly to the PARP inhibitor? Is this a documented response for some people to have a worsening of disease and if so, is there a way to screen for it?
Nice thoughts. The only certainty is uncertainty says it all.
I am also intraductal, and my PSA was 216 at diagnosis. 13 months before that it was 2. It can put out significant PSA and do so very suddenly.
How are your other numbers? ALP? Blood counts?
ALP 76 low hemo/hemacre
So, your scan showed progression, but the blood test isn't raising alarm bells yet, other than low hemo. My amateur opinion is that chemo sounds entirely reasonable, and better sooner while there's less cancer and you're better able to tolerate it.
I had early chemo and it knocked my ALP below 40 and now 5 months later I'm mostly recovered from the side effects.
Best of luck!
My doctor says both numbers would mean undetectable, keep up the fight ,
Don't worry. PSA fluctuates every time its taken.
True, Psa "fluctuates." Usually that means its either going up so action must be taken to stop that, or going down, where I get a respite, and may not need any treatment. But the only time it fluctuated with ups and downs that could not be countered was during my 5 shots of chemo, but average of Psa level indicated chemo had failed badly, Psa went from 12 to 50, as my onco predicted it would. He referred me to Lu117, and in the month after I quit chemo my Psa went down to 25, but I was still in big trouble with new bone mets and soft tissue mets seen in PsMa scans. During my years of ADT, Psa just went down to a nadir then up with no downs, no inexplainable reductions, Pca was asleep but growing slowly. Then Psa went up fast as ADT failed, then down after treatment and all was predictable. Where I had Psa measured at different labs but close in time the results were nearly identical. I found my Psa did not fluctuate because I'd had a blood test, or because I'd ridden a bike to get to the clinic, or because of anything I ate, or for any other reasons apart from treatment. For me, I learnt that alternative remedies were a complete waste of time and dough.
In early 2009, when I saw a slightly higher amount of Psa increase than during previous years, I saw the start of an exponential curve and thought I'd be getting Pca. The DX in late 2009 confirmed it. And a real bad DX, Psa only 6,
but Gleason 9, aggressive cells, young man's type. But the doc didn't know it was inoperable. He found out during attempted open RP in 2010. He would have known it probably had spread, so didn't say it had. CT scans did not show any spread, but this was 5 years before PsMa Ga scans were available.
My ADT suppressed the mets as well as at the primary PG site.
Patrick Turner.
True what you say. I was Gleason 9 with psa. After 24 months of ADT was down to 0.19. Fluctuated around 1.00 for a few months then doubled in just 3 months. Then jumped to 3.79 in one month.
So, the rate of increase and doubling is the worry not some fluctuations
That said your doctor is the one to ask.
In my case put me back on meds. CT & Bone scans showed no spread.
My question is: any treatment for those like me where no mets but came back - other than ADT?
These numbers are inconsequential. Question? Do you have a prostate? If you do your normal prostate will make PSA regardless of any cancer present. Nothing about it is constant and anything( yes anything) may change the value. These numbers are 400 times lower than what might be normal.Lets wait a little before we start second guessing.
Up and down and down and up. So Harry, "how's you PSA? Mine is down, UP YOURS?"
Fred, "UP YOURS TOO?"
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 08/28/2019 1158 AM DST - Pinnes.
my PSA has helium in it! ! ! 
PSA still undetectable
Zoladex increase in PSA
Prostate cancer but normal PSA?
Low PSA and PSMA scan 
