My husband has been on Zytiga only since April and his PSA has begun to climb the last three blood draws. Started at a leveled out 0.4 and then went to 0.5 and 0.6 each month consecutively. Now in this last month the current PSA went up to 0.8.
It is creeping up. Does this mean it's not working any longer or is there something else they can do or add in? I have read to change from prednisone to another steroid and I have also read to change to Xtandi?
Our oncologist is waiting until it gets to 1.0 and says it's back to Dana Farber for us...Is it too soon to assume it has stopped working?
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Lisaron628
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That's what I am thinking also but we are a bit on alert and scared so hubby asked for a sooner appt with the oncologist. Mostly for confirmation that all is still ok. I am thinking a scan will help him to feel better?
At what do you stress the need for radiographic scans? I’m confused myself as to discern when to scan and when not. Trigger point for just an effect I e CT scan is?
Well that's pro news and con news I think. In my body case: 1st Lupron Depot Sept 10; subsequent PSA & T labs Dec 10th 90days post showed PSA 1.100ng/mL and T-levels non-detectable. Ok, I'm 0.900 below minimum scan requirement norms.
Next up are my 45 days into Lupron#2 inj + Abiraterone (only 250mg) tabs Lab Tests(PSA and T-levels + liver and lymphocytes).
We shall see in 3 weeks what my 1.100ng/mL PSA drops to or stays at or goes up to...
Tall_Allen I shall see if I qualify to ask or insist on CT or Nuclear Body/bone scan. Probably not. Thxs...
To document clinical progression, I think it's a good idea to use whatever scan you had before - probably a bone scan/CT. Else how would you know if there has been progression or if you just detected what was always there.
Biochemical (PSA) relapse means that there is suspicion based on some arbitrary cutoff that true, clinical, relapse has occurred. Clinical relapse is diagnosed by radiology, biopsy, or symptoms rather than just a biomarker.
Kind of sounds like one depends on the other and vice versa. I’d like to try Clinical relapse. I’m still anticipating my 1st 2019 now it will be 1st 2020 CT scan Abdomen/Pelvis and NM total body bone scan. That I was deprived of by my MO in September....
He has already had Casodex prior to the Zytiga. He also has had 6 doses of Taxotere.
He is a 72 year old - diagnosed in 2012. Mets in 2017 to spine and then in 2019 spread to many bones and mild lymph involvement. He also has a crushed vertabra that can't have the glue product injected into it due to not having any room to insert it into.
Just feeling helpless and want to try to help in any way I can.
It's not working any more when there is radiographic progression, not just a rise in PSA. He can also switch steriods to Dexamethasone. That might slow the PSA increase or make it go back down (see SWITCH trial results).
Once it has been determined that there is progression, the best direction to go in general is chemo, then back to another anti-androgen such as Xtandi.
Totally agree. I had genetic testing when Zytiga/Predisone failed after just 6 months. PSA went from 0.12 to 0.5 in just 3 months, which was enough of an acceleration to warrant changing treatment. Was found to be BRCA2+ via genetic testing, and was switched to a PARP inhibitor Olaparib. PSA undetectable for almost 1 year now.
My husband was 72 when zytiga stopped after few months, chemo didnt work either. Gene mapping showed rare mutation, received Keytruda for MSH2. Now undetectable PSA. I agree gene mapping important in my opinion.
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