PSA is slowly rising with chemotherapy

[pmvc]

I have been with this PC from last 45 months. During this journey I have undergone docetaxel ( immediately after diagnosis) I am taking lupron from beginning every three months along with prednisone 10mg. Once in three months zolondric injection. Initially my scan showed skeletal metastasis and lymph nodes invasion. After two years my psa started rising from 0.15 to 0.58 and then to 1.15 and scan report showed growth in size . My MO advised to take abiriterone and after 6 months psa started rising again from 1.15 to 2 and then to 3.3 . MO started giving 2nd line of chemotherapy cabiaxital and now completed 7 cycles. My psa remained constant upto 6 cycles but present test showed 4.48 jumping from 3.4. MO advised to complete 8 cycles and then to go for psma pet scan. My question to dear friends is is chemotherapy is not working? If my psa again goes upward what is the option available. I heard of enJultamide but do not know whether my MO opinion. I am from India . Need some good advise

[Tall_Allen]

You can get Lu-177-PSMA-617 in India. I suggest you have both a PSMA PET/CT and an FDG PET/CT.

[pmvc in reply to Tall_Allen]

Thanks Mr Tall Allen . Any idea about FDG PET CT in India. I doubt whether they have

Any idea of LU 177 cost ? Is it not advisable to try Xtandi now. Please suggest

[Tall_Allen in reply to pmvc]

You should be able to get an FDG PET/CT anywhere - it is used for almost every type of cancer and has been around for a long time. I don't know the cost. You can try Xtandi too - in fact, you may be able to use it simultaneously if you don't wait too long - it actually increases PSMA expression for a month or two and may help the PSMA therapy work better.

[Shooter1]

When my PSA rose during chemo. I added Xtandi (enzalutamide) with major side effects at full dose. Cut several times and ended up with 80 mg /day. Knocked cancer for a loop and went into remission. Still suffering neuropathy but gabapentin is helping with symptoms but it won't go away. Best of luck during your treatments.

[pmvc in reply to Shooter1]

Many many thanks

[Hidden]

To determine whether the Cabazitaxel is still working you need to do imaging again and compare so I think your doctor is right to suggest 2 more cycles then imaging. Your PSA change is not very much, more important is whether there is radiographic progression.

After Cabazitaxel, you might be able to go back to another anti-androgen like Enzalutamide and get some more time.

[pmvc in reply to Hidden]

Many many thanks