Slight PSA increase ON CHEMO

Need some info and support. My husband had 4 chemo treatments. DOCETAXIL only. PSA was 18.6. Down to 14, then 10 and 8.6. This time it went up slightly to 9.4. I’m scared. Has anyone experienced increases? Now what?

[Magnus1964]

That rise could be caused by inflammation. Look for patterns in PSA rises, like three rises in a row.

[Hidden in reply to Magnus1964]

Even While on chemo?

[Magnus1964 in reply to Hidden]

Yes chemo can cause inflammation or irritations of prostate.

[Hidden]

I would not read anything into those PSA fluctuations, they are over a small range in an already low PSA. The main thing is that overall the PSA has gone down since the beginning of chemotherapy. Dead prostate cancer cells can also put out PSA, plus inflammation as already stated.

The key thing is: Is the treatment working? That needs to be measured by more than the PSA. Things like how you feel overall, pain and other symptoms as well as imaging. I would want to look at imaging to make sure there is no progression.

He still has a second-line chemotherapy called Cabazitaxel if Doctaxel is not working.

Has he had molecular testing done to look for treatable mutations? For example, if he has a BRCA mutation he could be treated with a PARP inhibitor.

[Hidden in reply to Hidden]

thank you or your response Greg I hate this disease I feel like I'm always looking over our shoulders. He feels excellent. NO PAIN Just fatigue Goes to work everyday My concern is that EVERY TIME he has had an increase it's meant the meds have stopped working. It felt like a punch in the gut and I know it was only .75 increase. He has had molecular testing. No BRCA mutations. I'm always hearing the determining factors are "PSA and how does he feel" So when the PSA went up instead of down i was surprised....3 short months and three treatments what the hell!

[Hidden in reply to Hidden]

A couple things to keep in mind about chemotherapy with CRPC. A 50% or more reduction in PSA is considered to be a good response. Many patients actually see their PSAs go UP initially after chemotherapy (around 20%).

PSA is one of those indications that becomes less important as we go along. The problem is it can be measured precisely, but the meaning of the values is anything but precise. It's easy to hung up on the "numbers" That's why we refer to it as Prostate Specific Anxiety. You have to look at the bigger picture when it comes to effectivity of treatments.

I know it's easy to say, "don't get hung up on the PSA" but I have to follow the same advice myself.

[Hidden in reply to Hidden]

thank you so much for taking the time to explain I very much appreciate it This does help

[Hidden in reply to Hidden]

One of the most difficult side effects is anxiety. I've found the best way to deal with that is to focus on the now.

[Dachshundlove]

The PSA can jump around on chemo. I think scans are far more telling. From one wife to another, this disease and the rollercoaster it puts us on, is very taxing. I think we need to start a PSA anxiety support group for the people here. PSA results have wrecked many many good times for the wonderful people here.

I second gregg57 The psa change is small and probably meaningless and If it’s not meaningless, there are other options.

[Hidden in reply to Dachshundlove]

When I have to look at my PSA before deciding if I feel good, you know it's a problem. We rely too much on one indication.

[Dachshundlove in reply to Hidden]

PSA is a menace on so many levels.

[Hidden in reply to Dachshundlove]

We can't let three letters control our lives.

[Hidden in reply to Dachshundlove]

Gosh you are so right! I feel like shit after yesterday. It sucks. And sometimes feel very alone in my feelings bc i do not want to stress my husband out Thank you for the reminder

[Hidden in reply to Hidden]

Loneliness has been a part of having cancer for me, but has also helped me to learn inner strength. The loneliest day of my life was when i got "The News". I still feel alone, but so much stronger now.

[Hidden in reply to Hidden]

Most times the experience for me has been a fight to try and be strong. Sometimes I am tired. Then I can feel badly bc it's folks like you fighting the battle to stay alive. The only place my strength comes from is faith in a Higher Power. Then there are folks like you who DO UNDERSTAND. And it really helps me. Thank you you warrior..... you are strong!

[Hidden in reply to Hidden]

I realize now that I am stronger than I thought. When I was first diagnosed, I was ready to give up from the start. What's the point of fighting? I even said that to my doctor. We become stronger when we face our challenges. IMO, life is all about learning and we can always learn from everything we have to go through here in this life. Having cancer has taught me SO much I have to admit. But I had to learn not to resist and accept. Accepting doesn't mean you aren't fighting. You can do both.

[Dachshundlove in reply to Hidden]

So true

[Dachshundlove in reply to Hidden]

I start getting really agitated days before a PSA test.

It’s so unhealthy and I don’t know how we will ever get better at managing this sort of uncertainty

Whatever happens you will be okay. And it really does sound like your husband’s treatment is working. Breathe deep and imagine a world without a PSA test...😊

[tallguy2]

I agree with my fellow travelers. A PET/Axumin or other scan will be very helpful once the chemo is completed. I empathize with your husband. I go to work every day, exercise routinely, look normal on the outside (except for the hair) and yet this mPCA is still in there.

There are many tools remaining in the toolkit if the scan reveals mets. Abiraterone may be next, and a second round of chemo after that.

Please have your husband stay active, eat healthy, non-inflammatory foods, and don't let this disease stop you from doing the things that you love to do.

[Hidden]

Talk to MO about Lupron with the chemo. There are plenty of studies that indicate the addition. I was in a trial in 2004 with did chemo and Lupron. Also it takes time for the chemo to bring PSA down. Took me 7 months after chemo to get undetectable and with Lupron.

[dadzone43]

Nothing to add to previous comments except my hope that you will learn to stop looking over your shoulder. The future is ahead or you, not behind

[Hidden]

thank you everyone To a good year ahead.

[Hidden in reply to Hidden]

We are with you.

[j-o-h-n]

You hate it..... Well I hate it worse than I hate my ex-wife.... now that's hate....

Bring on a better New Year for you and your dear Husband....

Good Luck, Good Health and Good Humor.

J-o-h-n Tuesday 12/31/2019 5:37 PM EST