I just finished my 8th and last Docetaxel infusion. My Oncologist says I'll get blood tests every 3 months. I think I'd like to keep an eye on my PSA and T more often than that. Opinions?
Thanks, Mack
June 11th 2019 - Diagnosed with advanced metastatic prostate cancer (lymph nodes, pelvis and aorta). PSA 450, reduced to 3, after 3 Docetaxel treatments.
kcamH,
I don't know the answer to your question about how often to get PSA tests but I'd like to pose a related question to you, namely, What numbers will trigger what actions on your part?
That may be a more important question than how often to get the tests. If you ask this question of a doctor you might just get an answer like, "We'll wait and see." But that answer is not as useful as it might be if you knew what you were waiting for and what you would do when you see it. So while you're considering the issue of timing of the test, you might also consider questions about things like, If the PSA goes up to X, I'll want to take another course of chemotherapy, or I'll want to consider more hormonal therapy, or whatever.
Those are hard questions and, since you haven't gone to medical school yourself or treated hundreds of patients, they'll be impossible to answer without professional help. However, I think they're worth thinking about and questioning your oncologist about. I think that may help you prepare for the future.
Best of luck.
Alan
Great answer.
You always have to think past any test and think about how the results will inform treatment decisions. IMO, if you feel that your current treatment is becoming ineffective and you are close to needing a change in treatments, then you might do more frequent testing.
I was in that situation, doing PSA testing every 3 months. As my PSA started climbing at castrate resistance, my doubing time was 3 weeks so I really didn't want to go 3 months. I knew I'd making a treatment change to adding Zytiga so I asked my doctor to recheck my PSA in 5 weeks instead of 3 months. My PSA shot up fast, so I ended up going on Zytiga after the 5 weeks. Once things stabilized, I went back to 3 months.
Of course PSA is only one factor in making treatment decisions. My doctor told me that we are treating the cancer, not the PSA.
Yeh absolutely right treating the cancer not treating the testing quantity’s
For what it's worth, I go in every month for PSA and CBC blood tests. Since Jan. 2018
This is an area where I've decided to trust my oncologist, and I'm getting my first PSA in 3 months next week. I am expecting to be undetectable again because my symptoms are slowly fading, and generally I'm feeling better each month.
I'm a bit philosophical about this. If the cancer is going to come back that fast and aggressively I'd probably have symptoms, and my time would be short regardless of testing frequency. If the cancer is going to stay away for a while, more testing is just more anxiety.
This maybe the difference between the two of us. I see my Oncologist 1st Nov after 3 months. I've been in pain since the diagnosis and a 3 month wait make me anxious because spikes in pain give me negative thoughts. It's balanced a little bit by the fact that so far he has done a great job and have to trust his experience. If I had no pain the waiting would be a lot easier to cope with.
You raise a great point and I try to be mindful of how lucky I am. I do have some pain, but much of the time it is negligible and well controlled with celecoxib. There are many moments where I entirely forget about the cancer. My response to treatment has allowed me to reclaim much of my "old normal", and now work deadlines and a looming half marathon keep me distracted from symptoms and side effects.
Most labs have walk-in blood draws available and you can obtain a PSA or any other test just by asking for it, no prescription necessary. You will have to pay cash (around $80) for these self-ordered tests...
When I was taken off chemo, (doce), then Cabazitaxel) my PSA doubling time skyrocketed to every 30 days and I let it get away from me...
Had RP 4.5 months ago. Urologist advised first PSA at 3 months.
I did my own research and found multiple recommendations for 4-6 weeks.
Went by them.
At 5 weeks, PSA = 0.02, by first lab .
Thought of having the next test one month later, but was dissuaded by urologist (guidelines follower).
At three months the PSA came 0.11 and 0.13 (first and a second lab from the same blood draw). RSADT = 24days!!!
Waited 4 weeks more, PSA=0.02, by a third lab.
Majority vote tie-breaking ruled for, yet, another test.
One week later, PSA=0.02, by a fourth lab.
As an engineer I can grasp measurements', errors, accuracies, variances, etc, far better than the average medic.
Bottom line:
Next PSA test after one month. After having established a rigid base line the sampling period will get increased.
Every month because I'm on Xtandi. Blood work and psa. A couple of days before I get my Xgeva shot.
It's like this.... you can have one every day, every week, every month, every other month, every three months and etc. whatever rubs your Buddha... (my Buddha likes his rub every 3 months)...
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 10/07/2019 12:16 AM DST
I’d suggest monthly blood tests. PSA, LFT, CBC.
This is just to ensure things are stable and you do not need additional treatments immediately.
In couple of months if blood work is stable and symptoms improve, you yourself would shift to 3- monthly with much more confidence.
In hospital with neutropenia following 1st cycle of Docetaxel. Considering discontinuing Docetaxel, is that reasonable?
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Abiraterone added to Lupron
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