New Member

[CutterJ]

I am 68 yr old male with stage 4 Prostate Cancer with bone mets. Have had two rounds of chemo which ended in Nov 2021. My scans seem to be clear, but my PSA continues to rise rapidly since then. What should be next?

[NWLiving]

Sometimes there is a PSA flare which is a temporary increase.

[Magnus1964]

If your PSA continues to rise you might consider Xofigo for bone metastasis.

[Scout4answers]

What is your PSA, What is your oncologist suggesting?

[CutterJ in reply to Scout4answers]

PSA is 3.7. Talk to oncologist on Tuesday.

[Scout4answers in reply to CutterJ]

If he does not suggest a PSMA - PET scan I would look for another MO immediately.

CT scans are worthless, mine came back negative and one month later a more powerful scan showed Lymph node involvement.

It would be helpful if you would post your entire history in your profile, there are many here that can and will help you if they know where you are at in the process.

[samuelachglue1952 in reply to Scout4answers]

Thank you for your posts.

😊

[Hidden]

Why only two rounds? Any treatments since November? Something is missing.

[CutterJ in reply to Hidden]

Maybe I should have been more clear. I had 3 rounds in 2018 and 3 rounds in 2021. Taxatore both times

[Hidden in reply to CutterJ]

Are you seeing a medical oncologist? 3 rounds of Taxatore 3 years apart seem out of the norm. Are you being injected with Eligard/Lupron.? If your PSA is rapidly rising you really need to find out why. If your course of chemo was 3+ months ago a flare can be ruled out.

[CutterJ in reply to Hidden]

Yes, I am seeing an oncologist at Ochsner's in New Orleans. Yes, I get Lupron every six months.

[Hidden in reply to CutterJ]

Our member dougnola has the killer mo in Nola. Dr Sartor I think ?

[GP24]

A PSMA PET/CT will show the mets causing the rise of the PSA value. Either radiate these and/or add Abiraterone.

[Tall_Allen]

Abiraterone should be next, or maybe Erleada. I think it's best to alternate chemo and hormonals:

prostatecancer.news/2019/12...

It doesn't sound like any of your bone metastases are painful. If they are, Xofigo and Provenge is a good combination.

How is your bone mineral density (DEXA scan)?

[CutterJ in reply to Tall_Allen]

I have taken Abiraterone, and have now switched back to Xtandi about two months ago. My bone density scan shows I have Osteopenia .

[Tall_Allen in reply to CutterJ]

If any of your metastases are large enough, it might be a good idea to biopsy it for a full analysis.

[Kaliber]

Welcome to the group brother

❤️❤️❤️

[Cooolone]

Would a bone sensitive scan be best? F18 over PSMA? To help establish what path might be most beneficial going forward? I'm asking for the OP out of curiosity, not as an answer...

[j-o-h-n]

Greetings CutterJ,

Here it comes (get ready):

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 Friday 03/04/2022 6:12 PM EST

[Poowater]

Ask your MO For Zytiga.

[jcoil]

I’m sad you’re here…but I’m glad you’re here. This forum is very helpful with a plethora of information and education. It has been my saving grace. I hope it is comforting to you.

[ishitasen]

Lu177 PSMA should be your next step.