PSA question

[Kentucky1]

I was diagnosed Stage 4 in February 2019 with PSA of 368. Started Lupron in March and Zytiga in May of 2019. I've seen a steady PSA decrease over the last year, however my last 3 PSA readings have held relatively steady at 3.68, 2.84 and 2.74. Can I assume that I have reached my nadir? I was hoping for that "undetectable" reading, but looks like that won't be the case. I still have my prostate. Is it reasonable that this is the new starting point to base my future treatment decisions. At what point do I look at changing therapy?

[Tall_Allen]

Good idea to change therapy when there is progression detectable on a scan.

[tango65]

Radiologic evidence of disease progression associated or not with increasing PSA.

[SPEEDYX]

Scans will determine as far as PSA my story very similar started jan 2019 350...firmagon after one month down to 22 started lupron zytiga in march PSA went up for 6 months to 39...was patient with zytiga finally started to come down than in feb 2020 was at 28 then in may down to 15....had couple scans during that time all good...praying for best next week for my 3 month checkup...still aiming for nadir longer time to get there might be a better long term remission

[RonnyBaby]

Sounds like you have reached your nadir - not everyone gets to 'zero' - perhaps it's time to re-evaluate the game plan because sitting around / above the 2.0 mark indicates some (re)action is still going on in your physical state.

It's no time to panic - you've already made the four year mark and your numbers aren't excessive.

Hopefully, you'll respond well to some added support ....

[j-o-h-n]

Not all Heroes reach Zero.... So start thinking about plowing ahead.... Speak and I mean Speak to your M.O.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/01/2020 12:23 PM DST

[Hidden]

First off...I'm not a doctor. But if I were in your situation I would continue with Zytiga until your scans show cancer progression. Remember, your treating your cancer, not your PSA. You still have primary chemo (Docetaxel ) in your back pocket. It's highly effective and not half as bad as some people make it out to be.

[Joes-dad]

I think you are doing good...your PSA is still going down. Going down slowly is fine. After almost 3 years mine is still going down. There have been occasional small upward spikes but then it continues to go down. You may see the same thing in your case. Did you radiation yet? (Not suggesting but just curious. )

Bob

[Kentucky1 in reply to Joes-dad]

I've not had any radiation treatments. My RO said he would zap any trouble spots that came up, but did not think it would be helpful otherwise. I am metastatic with lesions on my ribs, spine and pelvis. I hope to see continued reduction in my PSA, time will tell.

[Hidden]

You asked. For my money, I would hit it hard with systemic treatment. Yes, I am writing about chemotherapy and Lupron together. Hit your cancer while the tumor burden is minimal and your body is strong. This is very opposite to those who wait and “save” chemotherapy. Unfortunately by that time the tumor burden has grown and the body is usually weaken from the cancer....... research and ask your medical oncologist.

Gourd Dancer