Hello everyone
I feel extremely disappointed as I write this.My father's psa on 8th june was 73.Although the psa has been rising since january , he was suggested to continue with Lu psma treatment.He reveived his 5th cycle on 16 june.Today, his psa has skyrocketed to >1000 and alp is also >1000.The psma scan show progression in bones.
He is continuing abiraterone.
Last time I visited the MO ,he suggested not getting chemo as he has recently had covid(april).What should we do now?
You could use Actinium 225 instead of Lu177. This seems to be more effective against bone mets. Or get a chemo if possible. A genetic test could indicate Olaparib to be beneficial.
Sad to hear about sudden escalation of your father's prostate cancer. The rise in ALP along with PSA rise is not a good news. Please ask your Oncologist if he would re consider starting Docetaxel Chemo after reviewing his latest blood count numbers. Covid19 causes Neutropenia (low neutrophil count) but it becomes normal after the person recovers from Covid 19. Request the Doctor to check his blood counts again to consider early Chemo.
Docetaxel Chemo can help...Because Chemo kills both adrogen sensitive and androgen resistant cancer cells. Very high PSA is not a bar to use Chemo. In Fact, in general Docetaxel chemo is more effective in men with high PSA type PCa.
Thanks a lot for the response.Will see his MO tomorrow.
Latest scan showed mild scarring in lungs due to covid.
Would that be a problem with chemo?
Lungs have very high capacity. A mild scarring in one small area is not enough to cause problems. The capacity can be assessed by pulmonary function tests.
PSMA PET SCAN AND PSA
Psa
Rising PSA … Clear PSMA SCAN
Pluvicto and PSA 
