PSA went from 0.16 to 2.65 in 3 months

[Bdale]

Hello folks,

I just got the disturbing news about my PSA. I e been on lupron, abiraterone 250mg , hi and Prednisone for 2 years. During those years my PSA went from 11 to 0.16 last November. What kind of questions should I ask my MO and what type of next treatment steps does the community recommend?

Thanks for your help.

[mrscruffy]

I have been on the same treatment for 5 1/2 years now so hopefully you won't need to worry for a while. My MO said things are becoming available so fast that he has an idea but that could change 5 times by the end of the year as new things ate always coming down the pipe

[Hidden]

Ask about switching the steroid from Prednisone to Dexamethasone. You can often get more time out of Zytiga by doing that, it's been proven in clinical trials. It worked for me and has worked for many others.

Here's more information:

pubmed.ncbi.nlm.nih.gov/300...

[Bdale in reply to Hidden]

Thanks gregg57

[Tall_Allen]

You mean abiraterone 1000 mg, right? Try switching to dexamethasone.

[Bdale in reply to Tall_Allen]

No, 250 abi with low fat meal, i'll ask about dexamethasone.Thanks

[cesces in reply to Bdale]

Sounds like from TA that 1000 mg abiraterone is a more common dosing that 250mg.

Maybe ask your Doc about switching up the dose?

And then ask him to conjecture what direction he might take if that doesn't work after 2 months.

[Bdale]

Hi, I have had a full genetics test done at the University of Chicago Medical Center, thanks

[Bdale]

I also had a PSMA Pet Scan in March of 2019 before my radiation. I agree, I will ask for a repeat so we can compare the results.

[Magnus1964]

Have your PSA checked in a few weeks. If it's up again, then it might be time to take action.

[Bdale in reply to Magnus1964]

Funny you mention that, it was 2.0 two weeks ago. We were surprised so had it checked again and a week later it was 2.65, I'll talk to Dr. tomorrow see what he suggests.

[cesces in reply to Bdale]

"2.0 two weeks ago. We were surprised so had it checked again and a week later it was 2.65"

that is a darn fast doubling rate

[Canoehead]

I tried to call you last week. Hang in there my friend. Think of this as just another battle in the larger war. You’ll be fine. G

[Bdale in reply to Canoehead]

Hi G,

I know, I'm in much better shape than a lot of folks on this forum. Absolutely grateful for every day, the fight goes on. Be well.

[reconjj]

hello bdale , I just started my stage 4 journey . I just completed 3 fractions of SBRT to the 1 lymph node in the pelvic area , soon to get 25 days of SBRT to the pelvic region . I just seen Dr. Szmulewitz at U of C and he wrote the same script Zytiga , 250mg on a low fat breakfast . I gave that script to VA to fill and still waiting for that . yes if 250 mg dont work ask the Dr. for 1000mg fasting , or ask to switch to dex , with that 250mg. keep in touch . John

[GeorgeGlass in reply to reconjj]

Why do you say stage 4?

[reconjj in reply to GeorgeGlass]

Stage 4 , the cancer left the prostate and went into a lymph node . That is stage 4-N1 I believe .

[GeorgeGlass in reply to reconjj]

The American doctors don’t like to refer to it as stage 4 until it’s late stage advanced prostate cancer, probably because men can sometimes live with advanced prostate cancer for 1-2 decades or more. I know where you’re coming from though. It’s semantics. Hopefully we’ll live for a couple decades.

[33Ford in reply to GeorgeGlass]

Interesting, my doctors don't have any issue calling it stage IV. And that was from Dx. It is what it is.

[GeorgeGlass in reply to 33Ford]

Ok. Whatever you’re comfortable with is all that really matters.

[Bdale in reply to reconjj]

Hi, I also have Dr. Szmulewitz, talking to him at 1pm

[reconjj in reply to Bdale]

Let us know what the next move is after talking to him . . Thanks John

[Fightinghard]

My guess would be Provenge. Good luck with next treatment, whatever that turns out to be

[Bdale in reply to Fightinghard]

You are correct, but only if the PSMA PET SCAN next week shows no new spots, 3x Provence. If they do show up, radiation and either switch to enzalutemide or keytruda. Thanks for everyone’s advise and suggestions.

[j-o-h-n]

Prevail Bdale.............

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 01/19/2022 9:48 PM EST