PSA rising. The trend is not my friend. Part 2.

[LeeLiam]

About 18 months ago I posted the following:

healthunlocked.com/advanced....

Beginning of the previous post......

I'm in a pickle and would like to ask for your suggestions. The following is my PSA history. As you can see it is rising. The quandary is that those of us who have had radiation as our primary treatment still have a prostate in some form. My RO and urologist both said don't worry yet. We do get bounces.

Biopsy PSA dx 13.8

Gleason 3+4 (40% 4)

seeds 10/23/06

external beam 10/06-01/07

It took five years to get to 0.2.

0.2 (5/3/12)

0.2 (10/24/12)

<0.1 (5/3/13)

0.1 (9/15/14)

0.1 (11/27/15)

0.19 (11/17/16)

0.4 (06/09/17)

0.4 (10/23/17)

0.71 (07/20/18)

1.1 (02/28/19)

End of the previous post........

I got several wonderful replies. TA said may be prostatitis. AlanMeyer said recurrence seems unlikely. I was feeling optimistic. Most suggested that I keep testing my PSA at least until it goes over 2.0. Well, it has. It was 1.4 on 8/19/19. I intended to get it tested last March but the COVID virus scared me so I waited until last month (8/17). Now my PSA is 3.1. I assume that is conclusive of BCR. I checked the last five PSA readings in a calculator that showed a doubling time of 12.9 months.

I have an Axumin scan scheduled for 9/10, next week. However, yesterday I was looking at a link for clinical trials for PSMA and noticed my hospital had one. I emailed the doctor and he called me back within the hour. He told me I might be eligible for a new PSMA trial. He did not call it this but I think this is known as the SPOTLIGHT study. This one uses rhPSMA-7.3 (18F) PET. He said we would go ahead with the Axumin next week as a baseline and then do the rhPSMA in a month or so. They called this morning and scheduled me for a meeting with a radiation oncologist at the hospital on 9/21.

Does anyone have any information on this scan? TA, I searched your website but did not see it mentioned.

[Tall_Allen]

You are right that it is one of the several PSMA ligands in clinical trials. No comparative data yet, but the Munich trial looked excellent:

pubmed.ncbi.nlm.nih.gov/318...

[LeeLiam in reply to Tall_Allen]

Thanks, TA.

Does it look like it is better than F18-DCFPyL?

Also, do I need to be concerned with radiation exposure with two scans?

[Tall_Allen in reply to LeeLiam]

There have been no comparative tests. Radiation exposure is minor.

[Hidden]

Hey Leeliam. I too still have some form of a prostate after imrt five years ago. I did an orchiectomy to opt out of Lupron shots for life . I’m still on a test adt drug stopping adrenal production of t. For how long will it last? Only God knows my friend.? All of us stage#4 guys await the inevitable return.. I do like the optimistic Dr telling you bounces are expected at some point. It’s easy for them to say don’t worry. With an active APC it’s all worry .. The further I go with no PSA or t the closer I am to expecting the inevitable. ?? This is our dilemma in living with APC aboard us.I believe that there is much hope for you in this trial. Go for it! Save yourself again .. We all are watching each other’s progress. I m pulling for you . Because what is good for you in this trial can help others here as well. I’m the only guy here out of over 10,000 that’s still benefiting from my tak-700 test drug. The test was halted or failed for most . For me it’s a bit a a miracle so far. May you receive healing from this test ..

Good luck my man .💪.

[RonnyBaby]

I was on an ADT vacation for about 2 years. My 'T' recovered (I still have a prostate - had RT +)

Within the last year, my PSA went from 0.3 to 3.2 (as of Aug 1). That equates to the original DX - G9 - advanced + aggressive.

In your case the one year time frame is not significant enough (yet) to suggest an accelerated prognosis and need for immediate intervention - although I'd be monitoring every 3 months to see if a pattern is emerging.

We suspect a BCR (in my case) - and the next scans / action plan is about to be set in motion due to those numbers.

The doubling rate / acceleration rate is an important marker.

RT bounces DO occur.

Keep watching, and if the numbers dictate, take the appropriate action.

Wishing well on your journey ....