Any thoughts on why PSA rising but mets status stable?

[MacWong]

I am writing for my dad who was diagnosed with PCa in 2010, after using ADT, Abiraterone, Olaprib, Provenge(Car-T) and now his PSA is about 5.2, with 5 mets on lliac and neck lymphatic.

Last month we went for an enhanced CT to prepare for I125 to remove one of the mets, but result showed that all mets targeted were pretty small and the doctor suggested no need to go on treatment, but meanwhile the PSA kept going up.

Some of the doc. suggested to apply Chemo as the PSA shows positive development, but I am quite confused about the current situation as how this two features could be poles apart on the status, and I am afraid that it is still early for Chemo.

Anyone has the same situation? Any suggestions or thoughts are more than welcome, thanks.

[Tall_Allen]

(1) It is not too early for chemo. In fact, the earlier he uses it, the more effective it will be and the lower the side effects. It is tragic when patients wait too long and it can no longer do them much good, and the side effects are worse because the cancer has been destroying the body.

(2) PSA may be reflecting all the cancer that is still too small to be seen on scans. Don't wait until they grow bigger.

[MacWong in reply to Tall_Allen]

Hi Tall_Allen, appreciate for your help.I agree what you mentioned above, considering my dad lost weight in recent months, I think Chemo should be regarded as the next option.

So far he didn't feel any pain from bones, and doctor said some of the mets have already been calcificated, so that's why I thought it is still early for Chemo.

[tango65]

They could try to get a liquid biopsy to see if it is possible to determine the genome of the cancer and do IHC studies if they could get circulating tumor cells. Chemo or Lu 177 PSMA could be adequate systemic treatments which will treat the bone and lymph nodes metastases.

[MacWong in reply to tango65]

Thanks tango65, will do.

[tango65 in reply to MacWong]

Best of luck!!

[Hidden]

I don’t know anything about your Dad’s situation. Too early for chemo? ........ my first line after being DXd with metastatic prostate cancer in 2004 was a six month trial of chemo with hormone therapy. My thought process.... kill as many of the little bastards as possible through systemic treatment. Consequently I am biased with early intervention of chemo.... good luck.

GD

[MacWong in reply to Hidden]

Hi ground_dancer, thanks for your kind sharing, and glad to know that early intervention of chemo worked for you, giving me much confidence as well

[chips1942]

Hi, I know how difficult it is is caring for a loved one with PCa. I cared for my uncle for 11 years through many treatments. For me it was a gift to really get to know, respect & love him. Please share a little more information about your dad, his age, what specific type of scan he has had etc. Before you look for any additional treatment for metastatic prostate cancer based on PSA alone make every effort to get him a PSMA scan if at all possible. Also try to get a test to determine if he has any genes which may be affecting his cancer. That additional information will help you/your dad and his oncologist determine the best path for his treatment. Best wishes!

[MacWong in reply to chips1942]

Thanks chips1942, I hope this long journey could never be ended ...

[j-o-h-n]

More Bio information helps here. Thank you.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/29/2021 6:52 PM DST