PSA hit double digits, business is better, it is hospice for my brother, and I had a 2 hour and 10-minute elliptical session. 10.6 miles.

[Philly13]

I spent a good deal of time discussing my brother about four months ago. I won’t revisit in detail. We only have a couple of months to go. I am sad and it is stressful as hell.

I am a recruiter, and suddenly, I have several assignments, which is excellent, though very time-consuming. To be sure, this is a high-class problem.

Despite the above, I feel good. Much better physically than mentally, as illustrated by Sunday’s elliptical marathon. I also shot an 87 on a challenging golf course on labor day weekend. Please don’t tell anyone I played from the senior tees. It will be embarrassing for the 2018 version of Philly13.

I have trouble with the starter frequently, but the motor seems to be in good working order.

I am going to see the oncologist tomorrow morning. I have wanted to spend some time on the board to get help, research, and prepare , but I run out of gas late in the evening. I am both sorry and proud to say taking care of myself did not make it to the top of the list until now.

My PSA rose from the 4’s from October 2019 thru April 2020 to 6’s in May, June, and July. Then it was 9 in August and now 10.3 in September. The trend is not my friend.

I last reached out to the community when it went to 6 in June. I had a clear Auximen scan in March, though it said that several lesions had grown, but there was no evidence of metabolic activity. I switched to Dexamethasone in July from Prednisone. It took me four to five weeks to get used to the more powerful corticosteroid, but I am OK with that now.

The consensus of the oncologist, several on the board, and my opinion, was to look for physical evidence before changing treatment. I take Zytiga (generic) with Dexamethasone and get monthly Firmagon shots for ADT.

In any event, my current oncologist doesn’t really believe in the Auximen scan, but I have three previous years of this particular scan as reference points. So I think that is what he will recommend.

If he wants to add a bone scan, I am fine with that.

I would like to look for a PSMA Ga 68 scan, even if I have to pay for it myself if I can get one in time.

Something is going on, and I am now turning to care for myself. Getting to the bottom of the cause of what appears to be a rapid rise in PSA is an urgent issue.

I would appreciate thoughts and comments.

CMP labs have no apparent signs of cancerous growth. The ones I watch are ALP, which has been in the high 50’s since ADT started. It is now 86. A little higher but well with the normal range. LD is a little higher at 189 from 153. Everything else I watch is on-trend and generally at the low end of the normal range.

That is all for now. I will return to discuss what my MO says.

Thanks

Philly

[tango65]

There are clinical trials for the PSMA PET/CTs:

clinicaltrials.gov/ct2/resu...

clinicaltrials.gov/ct2/resu...

UCLA charges $ 2800

UCLA Nuclear Medicine

200 Medical Plaza, Suite B114

Los Angeles, CA 90095

PHONE: [phone]|FAX: [phone]

With a PSA of 10, the Axumin scans and the PSMA PET/CTs have about the same detection rate. If you have one of these imaging tests , you do not need a bone scan, which have a lower detection rate.

With an increasing PSA you could discus doing chemo with cabazitaxel and also see what your MO thinks about doing Provenge. If the PSA is increasing when taking Zytiga , your cancer is castration resistant.

[Philly13 in reply to tango65]

Thanks

[darlingdb]

I was referred to UCLA for the PSMA Pet Scan on 9/17/20 and had the scan on 9/23. For me the out of pocket was just under $3000 I was informed that the FDA approval has been delayed by COVID however it is expected prior to the end of 2020.

[monte1111]

So sorry about your brother, and your father. You are someone to be admired. Hopefully you can stop the trend soon. I have no advice, but certainly wish you the best.

[j-o-h-n]

Philly, I like you..... That's it.... (btw tell your brother I like him too)....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/25/2020 8:13 PM DST