Anyone have a PSA range that bounces ?

[Chris52981]

psa went from .22, .20,.15,.28 now two weeks later .31 - is this enough to panick. Or can labs differ and also every day to day differ. .28 to .31 in two weeks. Wondering if My dad will have to get CT scan and if he would be considered Castrate resistant. Also would this warrant a switch from Zytiga to another form of steroid or a whole new regimen.

[tango65]

0.28 and 0.31 are the same if you round the numbers (0.3). The clinical trials I participated always rounded the numbers to 1 decimal. The PSA went from 0.2 to 0.3 and the last 3 values are stable at 0.3.

[Chris52981 in reply to tango65]

Ok perfect so it should be ok

[Chris52981 in reply to tango65]

What is next standard of Zytiga fails and - is chemo really strong - my dad handles Zytiga and lupron well

[tango65 in reply to Chris52981]

If zytiga fails the cancer is castration resistant. He could request Provenge which offers a survival advantahe and chemo or Lu 177 PSMA or a clinical trial.

[Chris52981 in reply to tango65]

What about xtandi ?

[tango65 in reply to Chris52981]

When an anti androgen fails the best sequence is to use chemo (SOC) or outside SOC do Lu 177 PSMA. The anti androgens have cross resistance mechanisms, so if they are use when other anti androgen fail they work for a short time. Chemo could make the cancer to respond to the anti androgens again in some patients

[dhccpa in reply to tango65]

Seizing on that comment, which I've read here many times before, let me ask: why is Xtandi (much more expensive) ever prescribed instead of generic Zytiga? What's the advantage, and under what circumstances? Thanks.

[hansjd in reply to Chris52981]

I’m surprised no one has mentioned it yet, but before switching treatments try switching the steroid from prednisilone to dexamethasone. The switch can extend the effectiveness of the Zytiga.

[Magnus1964]

That is a very narrow range of PSA readings. I would not worry too much about it. They can be caused by irritations or inflammation in the prostate bed.

[dhccpa in reply to Magnus1964]

I suspect yours has fluctuated over the years. Is your profile history complete? I was planning to read it.

[Magnus1964 in reply to dhccpa]

No, I never put my detailed history on on this site. I don't think it would be very detailed. I could only give you the broad strokes up to the last six years.

[dhccpa in reply to Magnus1964]

Interesting. You mean j-oh-n didn't make his standard request?

Well, I'll bet it's a fascinating history. How come you never did? Privacy reasons?

[j-o-h-n in reply to dhccpa]

Goose and Gander request

Would you please be kind enough to tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 02/09/2022 6:06 PM EST

[Magnus1964 in reply to dhccpa]

I will put a detailed history on my homepage. I will let you know when I complete it.

[dhccpa in reply to Magnus1964]

I did read through your old posts. Quite a journey.

[j-o-h-n in reply to Magnus1964]

For the gang!!!

Would you please be kind enough to tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 02/09/2022 6:04 PM EST

[dhccpa in reply to j-o-h-n]

LOL. You're a national treasure, perhaps a worldwide one.

[Magnus1964 in reply to j-o-h-n]

Some of the dates may be fuzzy but here goes.

Diagnosed in June of 1992, PSA 39, Gleason 9

1992 Prostatectomy attempted, Cancer found in surrounding lymph nodes, Orchiectomy Johns Hopkins Hospital

PSA started to rise 1996 Started radiation to the prostate, Reading Hospital

PSA began to rise again in 2000, started Casodex

PSA went to and remained at less than .05 for 5 years

2005 stopped Casodex

2006 moved to another state, new Oncologist try to restart Casodex which did not work, Lourdes Hospital

2007 tried nilandron, worked well to reduce PSA but could not tolerate the side effects

2007 tried flutamide, worked well to reduce PSA but could not tolerate the side effects

2008 desperate to find anything I went on a 6-week treatment of a repurposed drug

PSA went from about 12 to 8

2008 – 2011 (with no other treatment) PSA dropped .01 points every 3 months

2011 PSA began to rise

2011 began drug trial with abiraterone and prednisone, LGH Health

2015 abiraterone start to fail after 3 1\2 years, PSA bottom 5.6

2015 Provenge treatment for lung nodules, very successful

2016 salvage radiation to ischium, PSA 88.8

2017 began drug trial with xtandi and a mystery drug PSA went as low as 6.5

2020 xtandi began to fail after 4 years

At the end of 2020 when I went off the xtandi trail I have not bee on any treatment

2021 to present, PSA hit a high 79, then mysteriously dropped to 47.8

[Shooter1]

Those readings mean just keep an eye on it....don't be scarred yet...

[TylexGP]

I wish I could give you an answer. I had a bounce after Brachytherapy while on ADT + Zytiga and then it continue moving down until last month when it went from 0.11 to 0.16. MO was not terribly concerned (I am but that's just me). MO's PA said when PSA gets that low there can be some variability. We will see. I wish you the best.

[Skippy3]

I had a similar experience. Got PSA measured locally and it was 0.07. A few days later I went to see Dr Sartor at Tulane to get my 6 month Eligard shot and his staff measured it at 0.03. He says no change in treatment until it gets to 1.0. That could be 2 months or 2 years. I talked to another Dr and he agreed. They look for a trend of constantly going up. Some people can bounce around a lot. If you see that trend start to worry. If not, try not to,

[Don_1213]

I'll just comment - I (by an odd circumstance of events) had two PSA tests done on two blood draws done one after another - the draws were no more than 30 seconds apart and through the same needle thingie.

The results were processed on the same machine and reported on by the same MD running the lab about 30 minutes apart. The results were 0.17 and 0.23 - so it doesn't even have to be different days, different machines, different readers.

I wouldn't be overly concerned. Mine has varied from undetectable ie <0.1, and 0.23 - and my MD's - all 3 of them aren't concerned. It seems to have settled in at about 0.2 (rounded off). That variation could be caused by a recalibration of the same machine.

BTW - I'm assuming by the numbers that your dad had radiation treatment. You might do a Google on "PSA bounce" - it's rather common for people who had radiation, and strangely enough, the reports on it indicate it's a good sign not a bad sign. It commonly happens 12-18 months after the conclusion of radiation OR the conclusion of ADT following radiation.

[Don_1213 in reply to Don_1213]

I'll just leave this here: ascopost.com/News/18642

"Key Points

Experiencing a PSA bounce was associated with improved biochemical disease-free survival.

A PSA bounce occurred sooner after radiotherapy than a recurrence of prostate cancer.

In total, 33% of patients experienced at least one PSA bounce." (fairly recent paper 2014)

and

journals.lww.com/oncology-t...

"Key Message

The key message, Dr. Horwitz said, is that having a PSA bounce does not mean the cancer has recurred. “Rather than initiating any additional treatment,” he said, “reassure and monitor the patient and repeat the PSA again in three to six months.”

His coinvestigator, Louis Potters, MD, Medical Director of the New York Prostate Institute, a practice and research center in Oceanside, NY, noted that patients typically become wrought with anxiety if they have any rise in PSA after treatment.

“Having data like these to point to and tell patients that a temporary rise does not represent treatment failure is extremely important,” Dr. Potters said." (older paper 2007)

And the Google will turn up several more - basically saying the same thing. Not a cause to worry.. perhaps a cause to celebrate (that's how I'm looking at it.. 👍

[Chris52981]

Thank you everyone I just worry about my dad so much, I just want to know there is hope for treatment and he has options

[Clotter1]

My psa has bounced from .5-14 and back downs. CT scans have shown no progression of my disease.

[j-o-h-n]

Being incontinent...... I dribble mine............

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 02/09/2022 6:08 PM EST

[Cooolone]

I'm going to assume you're self testing? And you forget to provide the timeline of tests, so I'll make additional assumptions...

Have you ever considered there's a legitimate reason why Oncologist have an interval by which they test (+/- 12 weeks)...?

Testing every other week, or even every month absent good cause will only bring heightened anxiety, as exhibited here! Testing so often provides no diagnostic relevance or improved resultant from any action. And yes, different labs and even different techs reading the blood sample can result in differences in results.

Also, the doubling time of any PSA progression is important, different than the static #...

Anyways, Best Regards!

[Chris52981 in reply to Cooolone]

No sept testing- 2 months ago .15 then two weeks ago .28 so oncologist wanted testing in two weeks to see if still with in range bc if not he would have madeMy dad get CT scan - my dad just getting pet scan and also have cystoscopy wanted to take a break from

Test he is wasn’t really necessary- I wanted to check with others on her to ensure this was ok

[Grandpa4]

Yes mine did a similar thing then after a year started to go up more consistently and I started therapy. I have a friend whose PSA hovered around 0.1 for 5 years then started to go up more consistently.