Rise in PSA

[chocolatelover_123]

Hello everyone,

I haven’t been posting much due to school and things have been relatively okay. My dad had a PSA test 3 months ago where it showed a PSA of 0.07. His PSA has been hurdling around 0.07 for a couple of months. My dad had his regular PSA check up today after 3 months and it spiked up to 0.11. He is on zytiga (he has been on zytiga since 2019) and getting hormonal therapy shots. His doctor said they will check his PSA again 3 months later and if there is another rise in PSA, then they will do a bone/CT scan and will possibly have to change treatment. I’m wondering what should the next treatment be in the event that his PSA rises? I know standard of care would be to move onto chemo, but is there anything else we can try?

[Tall_Allen]

Talk to his oncologist about switching from prednisone to dexamethasone:

bjui-journals.onlinelibrary...

[chocolatelover_123 in reply to Tall_Allen]

My dad has switched from prednisone to dexamethasone within his zytiga journey

[Hidden]

I wouldn't jump to conclusions. A PSA rise of 0.04 could be a result of lab error, time of day, what your father ate, etc. If he does get scans and they are clean then Zytiga is still effective. Try and squeeze every day possible out of Zytiga. It's the scans not the PSA.

[chocolatelover_123 in reply to Hidden]

Thank you!

[Magnus1964]

I would hardly call a .04 Increase in PSA a spike. If the next two PSA readings are up, the is the time to move on to another ADT drug.

[chocolatelover_123 in reply to Magnus1964]

Which ADT drug do you suggest?

[Magnus1964]

Either casodex or xtandi.

[chocolatelover_123 in reply to Magnus1964]

Would these still be effective after zytiga failing? I’ve heard that they don’t work for as long when zytiga is ineffective

[Magnus1964 in reply to chocolatelover_123]

I was on Xtandi after zytiga and it lasted for four years.

[chocolatelover_123 in reply to Magnus1964]

How long were you on zytiga for?

[Magnus1964 in reply to chocolatelover_123]

I was on zytiga for 3 and 1/2 years.

[Boywonder56 in reply to chocolatelover_123]

Erleada.....

[Dastardly]

Hi there,I am in a similar position with slowly increasing PSA. After chemo, I was undetectable, then it went to 0.12, then 0.16 and recently 0.19. My onco was not particularly bothered by this (although I was). He said PSA can fluctuate up and down when at low levels and that the measure they use is to look at the time it takes for your PSA to double. My GP told me that he wouldn't worry too much about rising PSA until it gets to 10.

It wouldn't hurt to ask your onco what he thinks sbout it though.

[j-o-h-n]

I believe that I've see here, that the magic number is 2.0 in your Dad's case..........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 02/26/2021 11:17 PM EST

[Boywonder56]

yes i concur with j.o.h.n....... 2.0....is when the alarm goes off.... .2 in some cases its time for dexa scan..