Docetaxel PSA decreased but new bone mets

[Rafa2]

Hi, I'm a 65yo, I had my initial diagnosis in Feb 2022 with 1000PSA, Gleason 8, metastatic prostate cancer with pulmonary, pelvic node, and bone involvement ( pelvis, spine, ribs).

I started my therapy in March with ADT + Docetaxel every 28/21days. PSA dropped to 13 last month and to 3 last week.

I generally feel good and blood tests are good too. I had a new TC, since the first one, that showed resolution of pulmonary mets and decreased size of pelvic lymph but unfortunately some bone mets (specifically on the pelvis ) are enlarged and new ones have emerged.

My Oncologist was a bit confused, he said that maybe it was not a piece of good news.

I'm planning new scintigraphy and RMN to figure out the problem.

Does anyone know anything about that? Is this a common problem?

Thanks

[Tall_Allen]

Has he started you on a second-line hormonal therapy yet? Good idea to biopsy one of those new metastases if big enough (histology, IHC, and genomics).

[dhccpa in reply to Tall_Allen]

TA, what's involved in biopsying a bone metastasis? How involved? Thanks

[Tall_Allen in reply to dhccpa]

It depends where it is, and how deep - a biopsy needle is used

[dhccpa in reply to Tall_Allen]

Thanks. None of my docs has ever mentioned over the last four years since diagnosis. Mine are either inside pelvis or on vertebrae.

[Shooter1]

When my PSA leveled out and started to rise during chemo, we added Xtandi and resolved all mets. At least for a while before BCR hit me after 3 1/2 to 4 years.... might need new second-line therapy.. Enzo or abi.

[tango65]

They should do a direct biopsy or a liquid biopsy ( with bone mets and a PSA over 10 it could be a good yield). If enough material is obtained they could do immunohistochemical, histological and genetic studies.

Those studies may indicate the next therapies .Possible treatments such as immune therapy with keytruda or similar, or olaparib or similar or chemo with platinum compounds or continue with one of the new anti androgens. The findings may also guide in selecting possible clinical trials.

[j-o-h-n]

Greetings Rafa2,

Would you please be kind enough to tell us your bio. Age? Location? When 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, you might want to copy and paste it in your home page for your use and for other members’ reference.

Note: Answers are for your benefit, not mine.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/16/2022 11:26 PM DST