My dad’s PSA has been doubling for quite some time now, he has PSA checkups every 3 months. It seems like Zytiga is failing/has failed. My dad’s PSA 11 months ago rose from 0.05 to 0.07. 6 months ago it went up to 0.11. Then 3 months ago it went up to 0.19. With today’s PSA checkup, his PSA rose to 0.34, which is not good. My dad’s doctor said that the “only option” right now is to do chemotherapy, and that if we want to start chemotherapy, we can. However, my dad’s doctor does not want to start chemotherapy yet because my dad’s PSA is too low. His doctor thinks that starting chemotherapy right now might make my dad’s health worse. He also said that clinical trials are not an option because a patient’s PSA has to be 2.0 or above. My dad’s CT and bone scan results came in a month ago, indicating no progression. My question is, what should we do? Are there other options that we can consider before chemotherapy that our doctor is not telling us about? Should we start chemotherapy right away? Why is my dad producing so much PSA consistently if scans showed no progression? Is there another scan we should do that can tell us something a bone and CT scan can’t? Should we get a second opinion? We are so stressed right now, we are just completely lost. So far the plan is to wait and monitor my dad’s PSA until it is high enough to start chemotherapy or clinical trials. For reference, my dad is on Zytiga (since 2019) with dexamethasone (he switched from prednisone to dexamethasone halfway through 2020). Any insight is appreciated, thank you.
Feeling Conflicted: My dad’s PSA has... - Advanced Prostate...
Feeling Conflicted
That is very little PSA. Have you discussed Xofigo?
We are planning to ask my dad’s doctor about it in the next appointment
I’m very proud of you advocating and loving your father .. conflicted even convoluted describes the workings of APC on the move . I don’t think these minutes changes speak to much right now . Take a deep breath ..and stay positive for him . Hang in there kid❤️
I agree with Tall Allen and Lulu700, that PSA is still very low .....and you are being a great advocate for your Father. Don't panic, don't stress . I'm sure others with addition knowledge and experience will post soon. I see nothing wrong with seeking a second opinion, but be sure it is from a very qualified Oncology Specialist with lots of experience and knowledge of the latest studies. Come to think of it, no one more knowledgeable about studies than our own Tall Allen.
Thank you!
Dear Caring daughter.. the consensus is that the rise in PSA is very slow and it is at low level. That means he can wait for chemo and continue with current regimen. I concur with above assessment of fellow posters.
Thank you for your insight!
If he's not having progression as seen in imaging, his treatment is still working. We tend to get upset a lot about PSA, but as my doctor says "We are treating the cancer, not the PSA" . I agree with the above suggestion: don't panic or stress. He doesn't need to do anything at this time accept continue to watch. His PSA is still very low. Down the road at some point, chemo will likely be his best option.
Do you know of any side effects to be aware of for chemo and how to deal with them?
Although your dad's PSA is still very low, it is rising. First I am not sure why his doctor removed his prostate if there were findings of cancer in the surrounding lymph nodes? Usually, the prostate is not removed in these cases because the chances for success is extremely low.
Your dad could opted for another drug instead of chemotherapy. Since he started with zytiga, xtandi would be a good choice
Also, has he been tested for genetic anomalies? Is there a history of prostate cancer in his family?
Relax there is time to explore other options.
I was only 12 years old when my dad had his prostate removed, I didn’t have that much input on his treatment during the initial diagnosis back then. But now being an adult, I’m learning that removing it might have been a mistake. We are planning to ask about genetic testing to my dad’s doctor next appointment, right now we are gathering all the information we can about next steps to take so that we can address it with my dad’s doctor. Thank you for your advice!
My dad didn’t have any luck with zytiga, I’ve been on Xtandi now for almost 5 years. PSA is staying at 0.05 . He might switch to Xtandi and see if it helps
Thank you!
We have had a similar situation, but higher numbers, my husbands PSA is also checked every 3 months. It went from 0.18 to 0.25, then 0.76, then 3.54 but scans showed no progression so we waited. 3 months later PSA was at 12 and scans showed that there was some progression so chemo has now started, he has just had his 2nd session. At the first session PSA was at 17, 2nd session was today so we don't have the results in yet but are hoping to see it going down again. The chemo has definitely brought with it side effects, and terrible fatigue, total hairloss already - if the scans aren't showing any progression I would be guided by your doctor - we have gained a full year of my husband feeling pretty good, and I don't think it has made much of a difference to the overall progression of the disease.
Wow thanks! How is your husband handling the side effects? Is there anything that can be done to combat the chemo side effects?
I agree with Tall Allen and others, that's a low PSA. Is there something you're leaving out or misunderstand?
Not that I’m aware of. My dad’s prostate cancer history is in the bio of my profile if it helps.
Hey dear chocolatelover_123, feeling same anxiety here... we found today my dad went from a 0.05 to a 0.09. I'm trying to bring the positive thoughts, that there is time to make the best decisions, to stay calm, breathe a lot and trust that there are high chances everything will be fine... sending you a big hug 💙
ps: I used to be so afraid of losing my dad, but with covid-19 (in the brazilian chaos) I understood that being young and healthy isn't a guarantee of nothing 🙂 now I try to live my life one day at a time, enjoy the most with him and my mom, say that I love them, make them nice food and that's it haha... none of us will last forever but I want to make great times while we are here together.
Thank you for your thoughtful words ❤️ I hope you and your family are doing well
I’m curious that the scans aren’t showing anything…do you have any specifics about the type of scan used?
All I know is that a bone and CT scan was done
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