PSA Rising

[Newyork6264]

This site has done well educating me so another question. My PSA started at 250+ in Dec and Alk Phos was 900+. In December I went on Lupron and Zytega. in March, and April my PSA was 6.9 and 5.7, Alk Phos 299 and 220. I had a scan in March that showed tumors shrinking. Today I got my May test results and my PSA went up to 7.0 and Alk Phos dropped to 190. My Oncologist didn't seem to concerned and said that some plateauing happens, especially after a dramatic decrease and said unless we see a couple more increases we won't change the treatment. He could tell I was concerned so moved me from a once a month test to every two weeks. My question is have any of you run into this?

[CalBear74]

Wow, you really slammed the cancer cells. My understanding is that they give up some PSA after so much widespread Cancer cell death. This would explain Your slight bump in PSA numbers. I have been on Lupron for close to eight years and it has worked very effectively.

[Magnus1964]

If I were you I would wait for one more PSA test. If it goes up again, it is time to act.

[Hidden]

Your Alkaline Phosphatase is continuing drop which is good sign. Hopefully that continues.

You just have to wait to see if the PSA continues to slowly go down, levels off or starts going back up. It could easily continue the downward trend.

I don't see the benefit of checking PSA every 2 weeks. For me, it would just add stress and reduce the quality of life which is what you are fighting for.

If your PSA nadir does end up being 6.9 and starts going up soon, I would get imaging done to see if there is progression and also biopsy one of the mets to see if you can find what's going on with the cancer because of the relatively short time period.

You might have a treatable mutation such as BRCA or ATM so it's worth finding out.

Short time to PSA nadir and castrate resistance tends to favor chemotherapy over adding anti-androgens as the next treatment.

Those are things to discuss with your doctor. For now, just have to watch things.

[Newyork6264]

Thanks for great response

[Tall_Allen]

Congratulations on the excellent response!

[Newyork6264 in reply to Tall_Allen]

Even tho it looks like it starting to rise?

[Tall_Allen in reply to Newyork6264]

Every silver lining has a cloud, eh? You got a good response - take the win!

[dac500]

Very frequent PSA tests can create a lot of anxiety in some men because of fluctuation of PSA result from one test to another. In my case of lymph node metastasis, I went on Lupron vacation after one year. I asked my oncologist about monthly test during the vacation. He said that three monthly test is good enough. I agree with him, but my paranoid mind doesn't.

Now it is said that Lupron may increase protection from Covid-19, or reduce chance of death from Covid-19. My dilemma is whether to ask my oncologist to restart Lupron, even when increase in PSA is very small. I am having blood works, chest X-ray, Abdomen CT scan, and whole body bone scan on May 28. This will be followed by a tele-health appointment with my oncologist on June 1.

[Newyork6264 in reply to dac500]

Good luck.

[Hidden]

I don't know much but a PSA test every two weeks would put me in a Psychiatric hospital. I have mine done every 45 days and that time period is enough to rise my stress level through the ceiling. Good luck.

[GoEZ]

Celebrate the win, it is a marathon not a sprint. You have been given good news. As time goes on you will get better with your information. A two week PSA test is a lot of information that tells you very little. A small change like your could be from many factors: test batch,tech, blood samples. My PSA has gone from less than 2 12/2019 to 99 yesterday. Enjoy your today.

[j-o-h-n]

You suffer from that common disease " New York anxiety"..... Take the good news to the bank and earn some interest on it.............Laugh....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/20/20202 10:15 PM DST

[Newyork6264 in reply to j-o-h-n]

Thanks. You are right. Need to quit looking at everything in the negative. Thanks again.

[SPEEDYX]

J-o-h-n right NY anxiety...I was at 350 went down to 22 and next 6 month crept up to 39 and now 9 months later down to 15...scans most important..I Am on same treatment be patient I know its hard!!!🙏