Update - a week or so ago I posted that since I started taking Zytiga on November 7, 2020, my PSA has shot up from 4.2 to 14.5 as of last week. I am on Eligard 6 - month shots instead of Lupron.
In 18 years of my battle, PSA never above 4.5 after prostatectomy. Met with my MO PA last week at Mayo Phoenix and she said let stay the course another 30 days then do scans. I have had a few bone mets for 3 years but no significant increase in size. I am worried the spread of the cancer while we are waiting. Has anyone experienced a surge in PSA after starting Zytiga before it started to work????
I don't think a single elevated PSA reading is enough to drive any conclusion as to what is going on as so many things can impact the PSA. Maybe its a bump from switching meds or its an infection or inflammation that will go away. You should take another test in a few weeks to see if it is a trend or a momentary anomaly. If it is a trend, then you might also want to get a scan done to see if the tumor or its metastasis are growing.
It almost always has an immediate increase in PSA because of cancer cells dying. But by 2 months there should have been a drop. Get a bone scan/CT to confirm progression. Talk to your MO about starting docetaxel.
Thanks TA:I am just so afraid that docetaxel and the long lasting side effects described from other friends on this site. They say the treatment is brutal and there could be life long side effects....... Scans in 2 weeks.
My Husband had 6 sessions of Docetaxel and to be honest he hardly had any side effects. A little tiredness and a little neuropathy in his hand s and feet but that disappeared soon after he finished.
He had 6 sessions, 3 week apart. PSA went from 320 to 1.5 our first line of therapyUnfortunately PSA started a slow rise a few months after, when Husband put on Caxodex, that did nothing really, Just started Zytiga 3 weeks ago
We are in the UK, where chemo for stage 4 metastatic PC is started straight away.
You can increase the effectiveness of the chemo, as well as minimizing the side effects, by fasting 3 days before the chemo and for another 24 hours after the chemo. I just reiterating the works of Dr. Valter Longo and Pr. Thomas Seyfried for while I've done long fasts several times, I never had chemo so I don't have firsthand experience with the combo.
You don't eat for 4 days and you drink only water (I switch between room temperature and boiled water just to mix things up ) and once or twice during the day I might drink something with insignificant calories or none at all like a cup of green tea. I've gone 18 days once and 5 days several times so you can do 4 or work your way up to it gradually.
Day 2 and/or 3 are toughest for most people so if your schedule permits it, maybe you want to start Day 1 on a Friday, watch Netflix from your bed on Saturday and Sunday and then on Monday you should feel no hungrier than you were on Day 1 because by then your body will have switched to transforming your fat reserves into ketones for fuel.
My husband followed that protocol of fasting and plant based foods only 3 days before chemo, day of chemo and day after chemo, starting at second chemo session and continuing for every subsequent session of chemo. Few side effects. I would encourage others to try this.
What you describe is extreme. I would be worried that it would weaken someone too much prior to chemo. We followed the fasting-mimicking diet and aimed for 800 calories a day. The people behind this have also introduced a commercial version aimed at anyone wanting to benefit from this diet .
Most guys I know personally who have had it tolerate it quite well. Several who are working continue to work through it. Remember that people who have problems are the ones who mostly post on this site.
Thanks TAYour candor is all always refreshing. I am really not excited about not feeling worth a crap for 18 weeks plus I'm a p**** to begin with. Been lucky so far in my 18 years with this crap and I guess a little chemo wouldn't hurt me. Picked up my third month prescription for zytiga so hopefully it starts working.
I'm on my second dose of docetaxel, nothing but mild flu-like symptoms the first week for me plus "brain fog" (short-term memory is bad, long term stuff I don't use is bad). My PSA was going a bit crazy as well after about a year of nothing so we chose docetaxel to do it's thing (read Tall_Allen's posts on it). I delayed my docetaxel by two months to change my diet and get into better shape.
I'm very fit & exercise, I eat very healthy (lots of greens, no dairy/eggs, minimal meat and only grass-fed, wild caught salmon, minimal fast carbs), CBD (THC's not legal in my state) and am a believer in high dose melatonin to minimize side effects. I've no idea what has made my chemo effects minimal but I'm very happy to not have the nightmarish experience I've read about - those stories gave me great anxiety but now I have none.
1500 when first diagnosed, it came out of nowhere as I had annual physicals which included PSA test. Initial standard treatment and removing my balls dropped the PSA to the usual near zero numbers. And then it started climbing again, switched ADT's and still climbed. Thus why I'm now doing chemo (docetaxel) to try to get another edge on this thing.
Look up dr Alan Frankel. He is the foremost cannabis expert. Nice guy, very knowledgeable etc. he has similar story as you so might be beneficial. Go into his site, if you choose you can set virtual appointment
you can send a question by email. Alex is the guy that answers emails and is very responsive. Julian works in the office to answer phones. They are all competent and super nice and responsive.
Giving till March 2021 to se if any decrease, if not will move on to my second chemotherapy of Cabozitaxel , I did Docetaxel, with hardly any side effects, lost hair but to begin with I hardly had any 😉
So let’s see what happens in March, Oh yes, I did gene testing and it came out Negative
No BRCA 1 or BRCA 2 🤔
So, for me just follow protocol where meds are concerned unless Zytiga decides to help 🤣
I think you ought to consider your good luck by being alive 18 years after diagnosis, and having had such a long time of unchanging Psa. But Pca that is now 18 years old has a tendency to begin to mutate and grow faster and old Pca cells die and are replaced by new cells.
I had Zytiga from 2017 to 2018, and Psa was 12 before, and it went to 2 for a few months then went up when it failed like all hormone manipulation drugs do, including all ADT, and Cosadex, Xtandi, and Zytiga. I got 8 months "benefit" with Xytiga, which is mean time for the benefit. Some get 2 years"+, some get less. I had a friend whose ADT failed in 3 months and Cosadex boosted Psa rise, so never assume what might happen when something new is done with treatment.
My friend died at 60yo from mets in his liver after 10 shots of chemo failed. Doctors ran out of answers for him. He lasted less than 3 years after diagnosis.
It would be a good time for you to get PsMa Ga68 PET+CT scan, and maybe FDG PET scan to better understand where your Pca is located and see what it is doing, or not doing.
I just had my 10th PsMa scan 10 days ago. It showed no mets in soft tissues, so having 6 doses of Lu177 since Nov 2018worked well for the usd $42,000 expense.
But I now have increase in many bone mets, with Psa about 30, increasing, so I was told today I could have Ra223.
I've lasted 11 years since diagnosis in 2009 at 62yo with Gleason 9 in PG but it was in-operable, so I've had the Long Fight.
Before Lu177, I did have 5 doses Docetaxal, and I see you fear the side effects. But my Psa went up from 12 to 45+ and by dose No 4, Chemo was declared to have failed, which entitled me to get Lu177, which IMHO worked better, with far lower side effect than chemo. But I am a keen cyclist, and I cycled every day during my "chemo time" and for 8 days after each dose of chemo I felt just horrible, but I cycled at least 10km. After 8 days, I increased the distance so that I was doing 150km a week and I cycled 17km to Hospital to get my chemo, and because other drugs they used, Dexamethasone I recall, I felt very well cycling home, overtaking a pile of other ppl cycling home from their work. I had an inject of neulasta drug to boost immune system within 24hours of each chemo dose. But next day I felt low, but managed to stay busy with craft work and the daily cycle seemed to help. I lost all body hair and toenails began to recede. The lasting effects of chemo were the neuropathy of my lower legs, where my feet became lazy and prone to tripping me up, while also becoming unable to walk on gravel. These effects are still reducing. Meanwhile my cycling speed is as good as it was 6 years ago. Now during the Psa nadir during time on Cosadex, in early 2017 I had both knee joints replaced by titanium + plastic. That kept me off the bike for 10 weeks, so I walked a lot with crutches then without. But then all the bike speed came back. But in 2018, I had chemo, and that had effect on surgery sites where much had been done on knees, so my side effects on legs from chemo were worse than if I had not had knee surgery. I have had virtually no neuropathy in my hands. So although chemo is damned horrible, I coped very well while having it and with its lasting side effects at my merry old age of 73.
Anyway, my next stop is Ra223, and maybe I have mix of Cabazitaxel + Carboplatin after Ra223, and I say that because Ra223 may not work as well as I think it might, because in theory it should, because my two last PsMa scans plus an FDG PET scan cannot find Pca in any soft tissue except for a tiny amount that stubbornly remains in my PG despite so much EBRT, IMRT, chemo and Lu177.
I live in Canberra in Australia where Lu177 was available in Sydney if chemo failed, and Ra223 is available right here in Canberra.
I think the doctoring by doctors here has been equal to anything I read about elsewhere in the world.
A Gleason score of 9 in Jan. 2019 with bone mets. Started Zytiga and Lupron and prednisone. Came of of Zytiga in October as PSA was rising. Started Xtandi and continued with Lupron and prednisone. By April 2021, PSA rising again. Was prescribed Taxtore chemo but had to be delayed as was scheduled for Carotid surgery in June. In July broke a vertebrae in my back and was in the hospital almost 2 weeks and had spot radiation on some of bone mets on ribs and spine which decreased PSA some. At end of July started Taxotere but after 3 treatments, PSA was rising . Have also been getting Xgeva shot once a month. After Taxotere failed have now been getting Ra223 injections. Have just finished my 4th one. Have 2 more injections to go. Should be finished with that in March. Still getting Lupron shot but no prednisone. My latest CT a month ago is mostly stable even though my PSA is still increasing. In the Spring will be trying Jevtana and whatever else they can try. On 30mg morphine 4 x day for bone pain in ribs and spine. Was taking 8 x a day plus methadone. Have good and bad days. Cannot walk a lot or stand very long. Stamina is still not there. Just keep hoping and praying .
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) and once or twice during the day I might drink something with insignificant calories or none at all like a cup of green tea. I've gone 18 days once and 5 days several times so you can do 4 or work your way up to it gradually. 
FIRMAGON LUPRON NOW ZYTIGA PSA
Lupron and Zytiga working, PSA 1000+ to PSA 0.02
PSA and Testosterone befor starting Zytiga ( abiraterone )
Interesting PSA progression on STAMPEDE Zytiga (Abiraterone) trial.
PSA rise on Zytiga
