PSA rising during treatment - Advanced Prostate...

Advanced Prostate Cancer

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PSA rising during treatment

Nickhmcg profile image

Would any of you know why my Dad's PSA is rising during treatment. He is currently on a Peace 111 trial (Xofigo & Xtandi with monthly zometa) extensive bone mets, some lymph nodes, no organ involvment. He has 1 more xofigo out if 6 left, but his PSA has gone up to 99.1 from 30 (June), he has CT scan and bone scans every 6 weeks which show disease is stable with some areas of healing, no progression. But I'm so confused why the PSA is still climbing, shouldn't the xtandi be bringing it down? He also has 3 monthly decapeptyl injections. Today he is having 1 unit of blood transfusion as his hemoglobin is down to 8.3, iron and platelets down too.

Many thanks in advance for your comments.

4 Replies

The best answer to your question is that you are not reporting anything we have not heard/read. When the scans are showing resolution of Bone Mets, and reduction in their size----what happened to the cancer cells? Well to answer-->when they died they threw off bits and pieces of their structure/body--in so doing they released their Protein Antigen---or more commonly called their PSA. The body will take time to rid these pieces of space junk. And usually, if the treatment is successful, there will eventually be a drop in PSA. The most important thing is what the scans are showing. And so far your scans are in your favor.


Massive release of PSA by death of a large number of Cancer cells can give this false picture. Watch and make a chart of 2 biomarkers.. PSA and ALP...if both shoot up and then, fall dramatically...that will confirm that the current treatment is working well.

I would like to call his rising psa as "Dead Cat bounce." (false alarm)

nicecity profile image
nicecity in reply to LearnAll

Thanks, I was worried because after taking Orgovyx for three weeks my PSA shot up from 5.7 to 8. But your explanation does make sense. But T came to 19.

PSA comes from recently killed cancer cells. It may be a sign the therapy is working. Hang your hat on the scans, not PSA.

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