3 months after finishing chemotherapy, my father had his follow-up appointment.
As you know, due to the pandemic situation, patients do not enter with family members.
Apparently, everything is as expected. The PSA value, although my father was unable to tell me the exact number, but it is at 2, apparently has dropped slightly. Wouldn't the normal be undetectable? The doctor said that psa continues to descend, which is a good thing.
It was scheduled for March, imaging exams (I think scintigraphy) and blood tests.
Anyone with similar results after chemotherapy treatment?
Wishes for a good Christmas, and a 2021 with good responses to treatments.
Thanks.
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JNunes
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I got the idea that I always read "undetectable" in the cases that I was seeing in the forum, and I got some fear of what it would mean to not present values below 1. I didn't know if it was common or expected ...
We had a guy in this forum who was diagnosed with Metastatic prostate cancer and bravely lived another 12 years. But.......his psa never fell below 3.0. Psa is just one factor in beating back the beast. Best of luck.
My Psa was 12 when I began Docetaxel in mid 2018. But it went straight up to 45, was 50 after 5 doses in about 3 months so I quit chemo and had 6 doses Lu177, and 2.5 years later Psa = 7.6.Chemo often does not work, and rarely does Psa drop to "undetectable" which is less than 0.005 here in Australia. Even if your dad had RP, there may be some Pca cells which were not removed during surgery and which have no Pca, but those cells make Psa. There could be some Pca cells not responding to chemo.
If ADT is not being used, then Psa of 2 is fairly low, and perhaps not a worry if the Psa is not rising fast, which means Psa doubles in say 3 months. Having ADT may make Psa go very low, but that only means Pca cells are forced into a coma and don't grow fast without testosterone, but this rarely lasts a long time and Pca learns to live without testosterone by making its own supply. Nobody may know if your dad has Pca mets away from PG.
Best type of scan here is presently PsMa Gallium68 PET + CT scan and done when Psa > 2.0
There is also FDG PET scan done using radioactive sugar.
I've had Pca since about 2004, diagnosed too late in 2009 with Gleason 9 so I could not have RP. Its been one treatment after another, and I have fewer options.
Thank you for this explanation Patrick-Turner. My Dad is having Doxetaxel now - his PSA has gone from 280 to 99 so far with 3 treatments still planned. His MO would like to get the PSA down to “very low” before jumping off the toxin bandwagon but we’re not sure how much his MS-ravaged body can take. Fingers crossed - it’s been such a horrible year for him.
280 to 99 is a good response so far. The MS must make things worse for him and yourself, and just how much chemo he could take remains to be seen. I had 5 doses, but Psa did not drop during the time I had those 5 doses, and went from 12 to 50, but after I stopped chemo, Psa went down to 25 in a month before I began Lu177. Nobody knows why. Lu177 gave me 2 good years without side effects. But Psa bounced back up in July this year, but now Psa has flatlined at about 7. But it will not stay flat, and Pca activity is bound to rise again.
Worst side effect of the 5 chemo shots were getting clumsy feet, and they seemed numb but I could not walk on gravel, so I had a mixed response where lower legs seemed both less and more sensitive at same time. Legs are slowly getting better. But I ride a bike a lot and have been doing average 220km a week for 10 last years, but with reduced km during times when I had RT and chemo. within last 2 months I have done some very fast rides that surprised me and doctors, at 73yo. So the chemo has not affected my athletic efforts, but I can imagine that chemo may make symptoms of neuropathy in hands and lower legs much worse if a man has MS.
I had a friend who died at 60 last year when his Pca didn't respond to anything the doctors tried for very long, and he had 10 doses Docetaxel and he watched Psa go from 40 to 2 in 2 months, then slowly go back up to 40 after 10 doses chemo. He was Brca 1+2 positive so they tried PARPs but that made Psa leap up to 432 in a month, and then new mets flared up in his liver and he became too sick to travel to get Lu177, so he just died in hospital while docs made him comfortable. He could barely use a mobile phone, and he knew he was going.... It was dreadful tragedy for his family who relied on him being main breadwinner. My point is that we all have to be resilient to things going bad with our health or that of a loved one, and I wish I had more answers about how to handle that vexation.
With Psa 99 about now, a PsMa Ga68 scan may show where most of your dad's mets are and if Lu177 could work well or not. But if you are in USA then Lu177 is hard to get, but although my Lu177 treatment here in Australia cost about usd $42,000, it was worth it, because other wise I'd be in frightful trouble by now.
I don't see my onco until Jan 4, and then maybe because my Pca is in bones I may get Ra223, even more expensive than Lu177. I have no idea how well Ra223 may work to reduce Pca in bones, but to me I have to gamble, and take the risk with whatever is available. Its possible I could have more Lu177 in future if more of my bone mets show up in PsMa Ga68 scans and indicate Lu177 would work again. I suspect having chemo may not work, but then I have not tried Cabazataxel or combinations of taxane based chemo with others based on platinum. There are 4 different levels of chemo locally available at my nearby Govt owned public hospital where its all free because our Medicare in Australia pays all costs for chemo. It does not pay for the 'nuclide' therapy but does pay large part of PsMa Ga68 scans, and I have had 9 so far at usd $500 each since 2016.
But without those scans, doctors had no idea what they were doing.
So I have been on toxin bandwagon for a long time with more to come, but I manage to have a QOL which many would envy.
Sorry for the delay - the holidays derailed me a bit this year. Your journey is/has been so arduous but also inspiring and gives us hope in many ways. Because of a 4-week derailment in chemo sessions due to basically an unnecessary weeklong hospitalization and 3-week physical rehab, not sure if the cancer caught up. So many prayers in my heart that the taxotere success picks up where it left off and yesterday’s resumption of toxins beats the cancer back a bit more to provide my Dad some relief. The MS as you mentioned is unfortunately a huge unwelcome mitigating factor. Thank you so much for replying and I hope your week has gone well.
To those who believe in prayers, I would always hope their prayers work. I never ask God for anything, as I fear he may be overwhelmed by millions wanting trillions of things. Maybe God knows all things, and directs the cancer cells to stop attacking good ppl so they may live to 100, at least. Meanwhile, I have to place my faith in science and I am due to get appointment to talk to a doctor giving Ra223.
My oncologist has faxed the referral, so wheels will turn soon.
I am not sure what Pca does when chemo is interrupted, then re-started.
But in 2005, during the time a sister had 4 chemo doses for her ovarian ca which spread widely to her internal organs, the blood test numbers indicated the chemo worked while it remained in her body, but its action stopped between doses, so by next dose of chemo she was no better, and finally after only 4 doses of chemo her digestive tract shut down, and she was told she had 2 weeks to live, and was transferred to a hospice situated on the beautiful shores of Sydney Harbour, a place she much loved.
She lasted 2 weeks. That's how I learned about what could happen when chemo fails. The response of cancer to chemo varies somewhat widely, and if Pca is slow growing, then its response to chemo is slow, and many doses may be needed because chemo acts on cells during their growth, when cells divide during their lives. I just don't understand this much, but if cell division does not happen often, chemo would have less effect than if cell division happened often. Usually chemo progress is indicated by Psa levels, and confirmed by scans. I have a friend of 80 who had an unknown type of cancer in his neck, so a big lump developed. He had surgery, and docs cut out all they could find, which was not much, then they gave radiation and chemo, and he fully recovered, but has a dry mouth as a side effect. All this was over 10 years ago and he's OK now, but then not much longer after that problem he got Pca, had an RP and that seemed a success, but 7 years later he needed 70Grey EBRT to his PG. His Psa is very low now, not increasing, so his medical treatments worked. My friend is not a man to pray, but has survived where others do not. The doctor who diagnosed his first neck cancer died soon after from a similar cancer.
So just how anyone copes with any cancer is extremely uncertain.
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