Need advice

[chocolatelover_123]

Hello everyone,

My father’s PSA has been increasing since last year. His PSA went from 0.34, which was taken 3 months ago to 0.53, which was analyzed today. My dad’s scans in the summer showed no progression thankfully. However, after today’s appointment, my dad’s doctor wants him to start chemo but I feel like it’s too early. Do you all think he should start chemo right now? Or is it too early? He will be getting genetic testing done to see if he can use other medications. For reference, he is on Zytiga right now with dexamethasone.

[Lyubov]

I believe it's not that straightforward. The "doubling time" is what the oncologist has told my husband. There are fellows here who understand & likely will explain it clearly to you. Good luck!

[Captsquid2u in reply to Lyubov]

Mine varies a little each time, now it’s up to 1. My onco says that’s alright.

[Tall_Allen]

Too soon. Wait for clear signs of progression- scans ideally.

[chocolatelover_123 in reply to Tall_Allen]

The logic my father’s doctor is using is that before things get worse and before the cancer spreads more we should do chemo as soon as possible. But I’m not sure if deteriorating his immune system with chemo is worth it if there are no signs of progression. Just on the fence about this.

[Tall_Allen in reply to chocolatelover_123]

Chemo can be done too soon. It increases side effects and has very little benefit if done too soon.

[tango65]

The cancer seems to be progressing when in abiraterone which is an indication the cancer is becoming castration resistant. He could wait to have a PSA close to 1 and get imaging done to see if there is progression of the cancer. If there is we should start chemo. At this time he could request to have Provenge a vaccine which could offer a survival advantage.

[Lettuce231]

Hi Chocolatelover _123, sorry to hear that Dads PSA is on the rise, sorry for you also.

I think that you are right to be very cautious about chemo, at this stage I would hang back and wait for the results to see what other treatments could be available.

Personally, chemo would be my last choice. Can you get a second opinion or is that very difficult at this particular time due to Covid ?

I hope that they can find a solution for Dad.