My father has been battling PC since April 2016. To make a long story short, his prostatectomy failed. Lupron worked for about 12-15 months until he became castrate resistant in Dec. 2017. He underwent radiation which didn’t appear to work either.. in Sept. 2018 he began Erleada which was lowered his PSA from 2.3 to 0.21 (as of yesterday). His PSA 3 months ago was 0.22. I’m possibly being paranoid but considering this was the exact trend when he failed Lupron, is this the beginning signs of failure?
He receives care at Emory and I have nothing but great things to say about the clinical staff. One of the ARNPs didn’t seem to be concerned and just said see you in 3 months.
What do you all think?
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ncisc001
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What is your father's age and general health? That would determine whether he is a candidate for chemotherapy or should start with ADT drugs i.e. casodex, zytiga, xtandi etc.
A PSA of .21 and .22 are basically the same number and a good PSA nadir. I know it's easy to get focused on numerical values, but it's best if we learn that they are just one indication. These numbers are good. It's more important to look at imaging to see if there is progression in the metastases. Has he had any imaging done? Does he have any mets?
I would relax and try to put cancer out of your mind. The point of these treatments is so we can live a normal life. They give us that opportunity so I feel like I shouldn't pass it up by thinking about what "might" happen some day. Cancer has taught me that the future is hypothetical and we have to live in the present.
My experience has been that sometimes the internal language we use makes a difference. For example, I prefer to think about a particular treatment as no longer working, for whatever reason, rather than "I failed" the treatment.
I also know first hand how overly worrying and fretting about an unknowable future can chip away at my happiness in the here and now. I've found that, for myself, getting too much down "into the weeds" of minor variation in PSA values can create undue emotional swings, either way. Many men have PSA readings that could just as easily be rounded off to the nearest tenth or whole number (or even the nearest 5 points in some very advanced cases), .... yet might not really add up to needing to either stop or start a particular treatment.
Living with the "big picture" and living with decision-making under conditions of uncertainty are things all of us here have to do. So often it isn't easy. Some days it's relatively easy for me to pull a Doris Day and sing to myself, "Que Sera Sera", and other days it's not. Oops! Sorry, .... must be the Lupron talking! Ha. Ha.
Charles, I had one blood draw where 2 different doctors requested PSA. Using the same blood the values were off 6%. Conclusion... The fidelity of the PSA test has at least a 6% fudge factor. Rate of change is far more important.
Try not to fret, look at the guys on here that are still fighting after years of treatment changes and that's what we all do, fight it.
My PSA is the lowest it's ever been after 5 years of treatment about the same as your Dad's. I am happy with it and continue to look forward to my next day and every day after that.
As far as I am concerned I don't think about it unless it's necessary, every step you take is a forward movement.
Yes to all those who are saying focus on life while you have it. All those with Advanced mPC are living their dying, all these treatments buy time. Focus on what you want to do with that time. Make it meaningful for you. If the treatment causes quality of life to suck, more time isn't worth it.
Life is a sexually transmitted terminal disease. At some point it's the best that we can do to do a good job dying and to figure out what that means to you.Until then, do a good job living.
Life is a sexually transmitted terminal disease. Wow! Life is terminal, agreed. Life is a disease? That makes me uncomfortable. I could be flattened by a bus. Life is a series of small diseases that is eventually terminal? I protest too much, I think. Congrats. A very nice turn of a phrase. Enjoy.
Hi ncisc001. My story is nearly identical, I’ve been on Erleada since March 2018. My PSA fluctuates up and down in the range of .05 to .1. In my experience, your father is responding similarly, I think he’s doing great!
I'm on Erleada as well, and my last several PSA tests were 0.21, 0.23, 0.26 and then this past month was 0.22. So I was also wondering if the trend was toward "stopped working" but my MO kept saying that these were all basically the same reading, rounding errors he said. So I was glad to see that this month is went down slightly to confirm what he said.
I think that catastrophizing everything is not good for you or for your father. The prostatectomy "failed"? No. It removed 98% of the PCa. The Lupron "failed"? No, it worked for a year until another cell line emerged. The Erleada is about to "fail"? No, he has stable PSAs. Look we all know it is HARD to live with PCa (or breast or any other cancer) but obsessing helps no one and hurts you. Hope you can let go of the obsession. Warm hugs.
Research “Darolutimide” a newer Erleada lookalike for future reference. Possible fewer side effects and longer time to ultimate resistance and failure,,,must be non metastatic patient currently. Ask your treating MO about it. As of now, I agree with others posting their thoughts, what your Dad is experiencing is not atypical.
Magnus1964 question above: What is your father's age and general health?
Where are you located? What was you father's Gleason score? Doctor's name(s). All this information is voluntary but helps us help your father and helps us too. Thank you.
He is 64 and in generally, good health. He had a triple bypass at the same time he was diagnosed but his heart is doing great.
I am in Miami and fly every 3 months to Atlanta for his follow up care. He is about 80 miles NE of Atlanta. His Gleason score was 9 at biopsy and then prostatectomy pathology showed it at 8. He has all his care at Emory with Dr. Bilen because I wasn’t satisfied with any of his local oncologists.
Thank you for the info, based upon your Dad's "details" he will be around for a very long long time unless the traffic in Atlanta gets him first....Tell to drive carefully so he'll be able to post here until here's 90....
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