PSA rising a concern? Mets to bones, livers, lungs and lymph nodes

[dch1953]

Hello everyone,

Just want to give an update on my dad (68) has mets to the bones, liver, lungs and pelvic lymph nodes, PSA 113, Gleason 4+5 upon diagnosis back in July 2021. He started Firmagon and then on Zoladex and then 6 cycles of docetaxel which finished at the end of November. His mets in general have reduced significantly in both the liver and lungs. His PSA was <0.02 in November, taken on the same day as his last cycle of docetaxel. He is currently just on Zoladex.

He is feeling and looking better compared to couple months ago. However on his latest PSA test, the PSA is now 0.053 which has almost doubled in 3 months. Is this a cause for concern? Is it time for him to add Zytiga to the mix? We were hoping to get more time on the Zoladex+chemo but the cancer is growing again.

Thanks,

[Tall_Allen]

Doubling time does not have any meaning below 0.1. Those are great numbers.

[Hidden]

Saying don’t be concerned or worried over a rising Psa doesn’t help anyone . Under .1 is still under the radar? Good he feel better than a few months ago . It takes time to recover after any treatment .. Your love will see him through... Take care of you self also . My dad had this too . I saw him fail two yrs after an RP .. A heart issue got him . Love you dad much . His is a serious pc . Keep up his spirits ! Take care .. 🕊

[tango65]

Great response . Radiographic progression of the cancer is what is going to indicate if something should be done, no the PSA values. The doctors will use the PSA values to decide when to do imaging studies,

[Hidden]

Undetectable. Anything <0.1. The problem with Ultra-Sensitive PSA test (uPSA) is the anxiety caused by fluctuations which by the way are common. Maintain the course. Listen to your MO.

[HopingForTheBest1]

Having visceral metastasis, such as to liver and lung, is definitely more challenging and needs to be monitored closely.

[dch1953]

Thanks everyone for the responses. Update: Had our appointment with the MO, essentially said the velocity of increase is very important. If his next PSA test in a month shows PSA above 0.1, he'll get him in for scans and then potentially prescribe Zytiga or Xtandi. He mentioned that if the first line of ADT stops working in under a year, the cancer is very aggressive.