PSA went up three years in a row rising to 5.09 when Proton Therapy commenced. Gleason was 7 and 6 at time of proton therapy. On Lupron and Zytiga currently. PSA now rising again to 6.33 and unsure of what's next. Appt. 4/30.
Proton Therapy failed. : PSA went up... - Advanced Prostate...
Proton Therapy failed.
Docetaxel would be next. You can also try Xofigo, possibly in combination with docetaxel:
Hi IdGump
Can you share where and who did the PBT? Was the PBT your primary treatment so now you still retain your prostate gland?
Jeff
Hey IdGump,
Have you had a mp 3.0T MRI showing the cancer, a tumor? An ablation therapy may well be a good choice. Imaging is most important.
Currumpaw
Greetings Mr. Gump,
Please tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
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Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 04/10/2021 12:55 PM DST
I am now 72. Diagnosed at age 66. Proton therapy finished 3/16. Gleason was 7 and PSA 5.38 at the time. Treated at Scripps in San Diego. Currently on Lupron and Zytiga and PSA rising to 6.33.
Hi IdGump,
I’m curious. Was your PBT doc Carl Rossi? If not, are you still being treated at Calif PBT? Dr. Rossi is the PBT for PCa at Calif. PBT. He may be a good doc to consult about this BCR situation.
Has your present RT or MO encouraged a PSMA-PET scan to see if the scan might determine where the primary tumor source(s) are for the rising PSA? Has anybody discussed focal PBT treatment of micro mets with you?
The reasons that I’m curious about Rossi and Calif PBT is because I’ve had a tele-med conference with Rossi about BCR if it occurs in my future treatment plans, and I found him helpful and knowledgeable. I do not have a prostate gland any longer, so our situations are different, but I wonder how the PBT docs will recommend handling your rising PSA and trying to pinpoint where the PSA rise is coming from.
Jeff
Agree a PSMA PET scan could be most helpful. If you are in So Cal UCLA is just up the road.
Hi Paul,
My thought too. I reread IdGump’s original posting to see if he was asking forum members for suggestions, and that isn’t clear. But, in case that was the point of the posting, to me it makes sense to get the PSMA-PET scan and send all of his data from the past half dozen years of PCa care to Dr. Rossi at ÇA PBT center for at minimum a télé-med consultation. That is where I’d start the BCR exploration. But, then again, I’m just an old man with PCa.
Jeff
Thank you both. I did have the scan you mentioned last January. It showed slight improvement. I have not kept Dr Rossi informed. That’s good advice. I will remedy that.
Good morning IdGump,
Just circling back with you. Have you contacted Dr Rossi yet and if so what did you find out? Where do things stand at this point with your treatment? Hope you’ve gotten some answers and have a plan defined.
Take care,
Jeff
Good morning: I have not contacted Dr. Rossi. I tried to make contact a few months ago and they were insistent on my current insurance information before I could speak to him. I was a bit put off. May reconsider. My current situation. PSA up to 13.6 from 6.3 in January. Scans today and Dr. wants to move me from Zytiga to Xtandi. Scans may dictate chemo, not sure. Obviously very concerning. Thanks for your concern. Best to you.
Hi IdGump,
Thanks for the quick reply. Yeah, all of the health facilities begin with how they’ll get paid and by whom, and then the communication doors open. The same thing occurred with my télé-med with both Dr. Rossi and Dr. Henderson at UFIPBT in Jacksonville. Rossi’s place probably considers you a new patient since they rebranded Scripps into the California PB Center.
What type of scan are you having? This summer, I’m considering flying out there to get a PSMA-PET at the LA VA, and then driving south to see Rossi in the flesh since I’ll be on the coast for the scan. Rossi is doing spot RT for mets discovered and identified after PSMA-PET scans, and that interests me. Is that something you might consider?
Sorry your PSA continues to climb. Does your treating physician feel that treatments other than with ADT and/or chemo may be worthwhile?
Stay in touch, and good luck.
Jeff
When you had the proton did you have ADT like Lupron for at least a year and brach. seeds along with the proton?