I have an appointment with my oncologist tomorrow for a Firmagon injection and general visit. My PSA was over 100 when I started on Firmagon and Zytigamaybe 5 months ago. It has been dropping very slowly and no one seems to have a good explanation. I just got the results of a bone scan and there are bone mets in a few locations including one huge one (could be something other than PC) where I have no pain. My PSA is now 12.26 down just a little from the last two 3 weeks and 7 weeks ago which were 12.56 and before that here is a little chart of recent PSA. The question is, why is the PSA going down so slowly? Does this suggest that some of the PC is castrate resistant? I am taking oxycodon for bone pain so i can sleep so I don't know if I still have bone pain. Before the last PSA and scan I had an appointment with Dr Aggerwal to discuss the possibility of PSMA/Ketruda trial for which I do not yet qualify.
4/27/2021 12.26
3/25/2021 13.23
3/8/2021 14.97
12/21/2021 11.1 after starting Firmagon and Zytiga
10/28/2020 110.06
Written by
spencoid2
To view profiles and participate in discussions please or .
You are not castrate resistant as I understand if you are still going down or stable. Enjoy the ride as long as it’s going down albeit slowly. Have the mets been shrinking or growing or is this your first scan?
Castration resistance is a continuum rather than an either/or type of thing. Everyone with metastases have some cancer cells that are castration-resistant. Keep going with the Zytiga until your PSA reverses direction or there are new metastases.
I remember a few old threads on the rate of PSA decline, prompted by studies that showed a lower rate to be better. Seems counterintuitive, I know. The longer the time to reach PSA nadir, the better.
Plenty of PubMed hits for <prostate "time to psa nadir"> [1]
e.g. "... and TTN {time to PSA nadir} <6 months had shorter PFS {progression-free survival}" [2]
A faster rate of decline implies a shorter time to nadir IMO, although some might quibble.
My husband's PSA was 113.3 and testosterone was 300+ in March. The next month PSA was 4.2, and testosterone was 0. he is on a trial of Orgovyx 120mg, and Fenbendazole 444mg capsules not a prescription.
In my case, PSA went from 840.2 on 12/01/2014 down to 55.9 in 03/2015 with ADT/Chemos. I finally reached a PSA nadir in the Summer of 2017 at 0.1 for three months.
Took a Lupron holiday break and restarted Lupron on 12/2018 when the PSA hit 10.2.
Abiraterone began in 01/2020 with PSA at 11.7, then Xtandi 09/2020, but PSA still rose
Did another round of 6 Taxotere sessions (Had 15 in 2015) and that seemed to work as the PSA dropped to my lowest at 3.1 on 04/20 since the 3 in 03/2018.
I hope that this may encourage you a little, I didn't have the problems that you have, but the cancer had gone outside of the prostate.
My PSA was over 150, I think it got to about 152. After a series of different treatments and a bouncing PSA, I was put on Zytiga, prednisone and the equivalent of Lupron.
Seven years after diagnosis, the PSA is still falling , latest is 0.039.
The important thing for you is that it's decreasing, speed is not important. Try not too worry over that, you are doing well.
I came across this health.harvard.edu/newslett... which also refers to fast time to PSA nadir not being so good. My husband had PSA above 90 in mid-August which came down to 0.56 by mid-October. But within a few more months, it had started to creep up, and at last count was 4.7. So from our experience, slow decline is not a bad thing.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
PSA is relatively low, but I am having bone pain in my pelvis and spine
PSA rising slowly since Nov 2022
PSA going down. Would like opinion from TA
6 weeks after radiation my PSA is still rising
Rising PSA - 
