Psa going up and oncology acutherapy

[Echotango51]

I had my three month lupron injection on the 8th, Friday . My URO call me that afternoon and told me my psa went from 0.19 to 0.46. I asked him if he wanted to recheck in about a month, he told me no. My next appointment with his is July 13th. After I got over the sock Saturday morning I emailed my MO at MUSC to get his thoughts . I should hear from him this week.

My daughter sent my so info on oncology acutherapy from Emory in Atlanta. Does anyone know about this and does it have any effects on PC.

ET

[MateoBeach]

Well that is unfortunate. You are now most probably castrate resistant. You need to switch care to a Medical Oncologist immediately. Will probably add an advanced androgen drug to the ADT. Most preferable would likely be abiraterone plus low dose prednisone. Much discussion and experience on that reported in this forum. Brand name is Zytiga but is now available as generics. Seek out referral to receive Provenge immunology treatment that you now qualify to have covered. It extends life in APC and is approved for mCRPC.

I would request a PSMA-PET scan (Pylarify) to see where the cancer is growing. If in bones, or if you have any degree of osteopenia on. DEXA scan, then consider requesting a bone protecting regimen such as Xgeva.

Time to step up the fight, ET51. Find out who is the best and most progressive MO in your area and get in there promptly. Paul

[Echotango51 in reply to MateoBeach]

Thank you MateoBeach for your reply. I have a Medical Oncologist , he’s at MUSC in Charleston S.C. he has me on a list for the PSMA-PET scan [Pylarfy]. I email him when my psa reached 0.46. I’m waiting on a reply from him. The way my psa is going up, in 3 months it will be some ware north of 0.8, then I will get the PSMA scan. My URO is talking about xtandi, erleada or nubeqa. He can also sent me for Provenge if I decide to go that course. The Medcal Oncologist that wants to find the pc and kill it. He’s a Doctor that looks for a cure not just treat you like your a diabetic with no chance for a cure.

[MateoBeach in reply to Echotango51]

Good to hear, Echotango51. 👍

[Tall_Allen]

It could be that your previous Lupron shot had worn off and your testosterone was starting to rise. Did he measure testosterone at the same time?

If your testosterone levels are low, and castration resistance is beginning, you may want to confirm in a few months. If PSA is still rising, you may want to get a bone scan/CT (NOTE: NOT a PSMA PET scan). If negative, you will qualify for any of these: Nubeqa, Erleada, or Xtandi. If positive, your choices are: docetaxel, abiraterone or Xtandi.

Acupuncture has a proven benefit in reducing hot flashes. Other than that avoid whack-jobs who make a living separating cancer patients from their money.

[EmpireGradeCyclist in reply to Tall_Allen]

Just curious why you would not want to get both a DEXA scan and a PSMA scan to detect any PCa?

[Tall_Allen in reply to EmpireGradeCyclist]

(1) DEXA does not detect cancer, it detects bone mineral density. If he has osteoporosis, Xgeva or Zometa may be a good idea.

(2) I thought I explained why a PSMA PET scan is a bad idea for him now - please re-read why I wrote. There are several excellent medications (Nubeqa and Erleada) that are only approved for patients who are castration-resistant and non-metastatic on a bone scan/CT. If a PSMA PET scan shows metastases it does not qualify him for those drugs.

[EmpireGradeCyclist in reply to Tall_Allen]

Thank you for clarifying, with your usual deep insight. I’m glad you added that detail - my MO told me last week that I have osteoporosis (@48!) based on my DEXA scan, and now I understand the difference between that scan and the PSMA (which I have not had, just an MRI).

[Echotango51 in reply to Tall_Allen]

Thank you TA, my testosterone was checked 1/5/22. The results show 0.00 ng/dl. My uro will check psa on July 13th, he’s talking about xtandi or Nubeqa , I will know in 3 months. I’m still waiting on my MO from MUSC to contact me hopefully in a few days. He’s wanting to do a PSMA Pet scan when my psa is > 0.5 at the rate it’s going up I most likely will be at 0.8 or 0.9

[Tall_Allen in reply to Echotango51]

Really important to get the bone scan/CT to qualify for Nubeqa, Erleada, or Xtandi. You may have insurance issues if you don't get one.

[Echotango51 in reply to Tall_Allen]

Thank you, will check with my uro in July.