Need suggestion PSA 878 after one mon... - Advanced Prostate...

Advanced Prostate Cancer

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Need suggestion PSA 878 after one month of 3rd Chemo

Vasanta profile image
12 Replies

Before Chemo start PSA was 499 after 2nd Chemo PSA was 150.

The initial plan was Docetaxel 50mg/m2 in 100ml NS over 1hr -- 75mg over 2weekly.

However, due to low platelet count and HB count, his chemo was pushed by 1 or 2 weeks.

we had 3rd Chemo on 13 Jan 2021.

Doctor asked to stop chemo. we asked him about any other option he said none.

when I asked about nuclear pharmacy then he referred us to the nuclear medicine department. I even asked him about starting abiraterone acetate he rejected stating it will not work

we have PSMA Pet CT tomorrow, and the doctor said may give nuclear on 16 Mar 2021.

My question is, My father PSA rise is very fast, I was hoping they could give some medicine which is better than giving no medicine other than pain killer/morphine

Creatinine 0.8

ALP 161

Can we give him Bicalutide or Abiraterone, is it harmful to take these medications after chemo? (he already took this medicine before and stopped after the medicine was not working)

As his PSA is moving fast even if there is a small effect of medicine we could identify by a blood test, I am planning to test blood 2 times /week.

I don't know what should I do.

His pain is increasing day by day.

Thank You all for all your help and suggestion

I find this forum very helpful, as we all have one aim "To Defeat APC and we will"

Friends, our case is an exception so please don't get upset with our results as most of the folks respond to treatment well.

I believe in miracles as I have seen many miracles in my life.

God Bless You All.

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Vasanta profile image
Vasanta
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LearnAll profile image
LearnAll

Vasanta...as you already know that PSA is a marker of how fast androgen dependent prostate cancer cells are growing....But PSA alone does not tell the entire story ...To know what really is going on in bone lesions and how fast they are growing, we need to track Alkaline Phosphatase...which is an indirect measure of bone repair and therefore indicates bone damage at a given point of time.

Anti Androgen meds like Bicalutamide ,and meds like Abiraterone etc can be used after chemo..in fact many doctors prescribe them to knock down the growth of cancer cell growth. Its a uncertain whether these meds will still work or not. I have read that after chemo, these meds RE-GAIN their effectiveness in many men. Its called Re-Sensitization of meds.

With PSA running fast like an express train, every measure should be taken to stop this train. and ask doctors to be more aggressive with treatments. Not to mention the urgent need to control pain by various means. Best wishes.

Vasanta profile image
Vasanta in reply to LearnAll

Thank You LearnAll

every word you said has raised hope in me, just few minutes back I bought bicalutidewill start giving him from tonight and will buy abirateron acetate tomorrow.

LearnAll profile image
LearnAll in reply to Vasanta

Keep us informed about outcome of this "PSA Circus" for our understanding of behavior of PSA.

Zhyravlik profile image
Zhyravlik

hi! Actually my father started abiraterone after 4 rounds of chemo (docetaxsel). And it is working. We don`t know PSA yet, but you don`t need to measure it, because he feels much better. And pain is gone. What treatment did you father had before chemo?

Vasanta profile image
Vasanta in reply to Zhyravlik

I wish and pray for your father health

initially we started with 1) Bicalutide 50mg it helped to take PSA down

from 3045(Mar 2019) to 20(Sep 2019) then PSA started going up so

2) we switched to Abiraterone Acetate 1000mg it stopped working in Jun 2020 and

3) we switched to Enzultamide in Sep 2020 till Nov 2020

4) Chemo 1 -27 Nov 2020

5) Chemo 2 - 20 Dec 2020

6) Chemo 3 - 13 Jan 2021

will give Bicalutide 50mg today

Tall_Allen profile image
Tall_Allen

Do not give him bicalutamide. The cancer learns how to use it as fuel, and it makes the cancer progress faster if he takes it. With docetaxel failing, it is unlikely that the stronger hormonals, like Zytiga or Xtandi will work on rechallenge either. They may make it worse.

Are his metastases in bones? If so, Xofigo may provide some relief. But Lu-177-PSMA may be a good choice too. He should have both a PSMA PET scan and an FDG PET scan the next day.

Peterd110 profile image
Peterd110 in reply to Tall_Allen

I thought docetaxel may re-sensitize drugs like zytiga ??

Tall_Allen profile image
Tall_Allen in reply to Peterd110

It failed, so I doubt it would.

Vasanta profile image
Vasanta in reply to Tall_Allen

We have PSMA PET scan tomorrow morning.Docetaxel was taking PSA down for few days but again it starts rising.

what test we should do to find if bicalutamide\Zytiga working or not?

about Lu-177 or 223 we will get to know tomorrow , the earliest date they suggested is 16 Mar 2021 that's almost like a month

Tall_Allen profile image
Tall_Allen in reply to Vasanta

There is no test- just avoid them. Bicalutamide withdrawal syndrome (cancer feeding on it) is well known. Abiraterone withdrawal syndrome is less common but has been found.

Zhyravlik profile image
Zhyravlik in reply to Tall_Allen

I have a question 🙋‍♀️ My father started Zytiga after Docetaxel. And he is castration-resistant prostate cancer now. In the treatment protocol for 2020 in Russia, it is indicated that ADT should be added, because it prolongs life. He will ask his doctor next week about that. But if they will give him bicalutamide, should he resist and for another one?

Tall_Allen profile image
Tall_Allen in reply to Zhyravlik

He should have been taking ADT all along, and shouldn't stop. ADT should consist of injections, not bicalutamide. But perhaps I don't understand. Rather than get diverted, please send me a private message.

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