PSA continues to rise after 7 rounds... - Advanced Prostate...

Advanced Prostate Cancer

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PSA continues to rise after 7 rounds Jevtana/Carbo combo

HopingForTheBest1 profile image

After my 1st round PSA dropped over 90% to 4. From then on it has steadily risen, usually doubling after each round. Now, after 7 rounds, I am up to 41.2. I am not happy, and a little less hopeful.

Next step will be to have repeat scans within the next week. If no indication of progression, chemo will continue. Otherwise, will need to change treatment to something else. Possibly Pluvicto. As time goes on available options are becoming fewer and fewer.

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HopingForTheBest1
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22 Replies
watertender profile image
watertender

Good luck to you, looks like you have been pretty aggressive in fighting the beast so far. Hoping your next scans will be favorable.

dico profile image
dico

Good luck with your scans next week. Please let us know the results. Like you, I am hoping for the best.

tango65 profile image
tango65

If you could, consult with Dr Beltran at Dana Farber in Boston.

beltranlab.dana-farber.org/...

I would look for clinical trials, for example Car T Cells at City of Hope, with Dr Dorff.

cityofhope.org/tanya-dorff

HopingForTheBest1 profile image
HopingForTheBest1 in reply totango65

I contacted Dana Farber to find out if Dr Beltran would do a second opinion consult via telemed. Waiting to hear back.

As for CAR T, isn't this considered a last resort trial therapy?

tango65 profile image
tango65 in reply toHopingForTheBest1

These are links with preliminary results about CAR T Cell treatment in PC

meetings.asco.org/abstracts...

meetings.asco.org/abstracts...

SeosamhM profile image
SeosamhM

Ugh...this is a dreadful post based on PSA, Hoping. Fingers crossed that there is no progression indicated on your scans.

I have always been confused as to the real impact of "PSA flare" during therapies and their impact on our treatment plans. Is what you are experiencing still some sort of "flare"? If scans indicate no progression, it seems as if you and your team are still full speed ahead with the J/C combo and you have to wait from scan to scan to see if you move on through a dwindling PCa arsenal.

As Dico says: "Like you, I am hoping for the best."

I am not an expert on any of this but I think I have read before that when cancer cells start to die after treatments (chemo), it puts psa in the blood stream and may be may be this is the reason why the psa is rising?

HopingForTheBest1 profile image
HopingForTheBest1 in reply toStayingOptimistic

Yes, I have been told that. The scans should be able to tell if the disease truly progressing. If not, will continue chemo combo. If yes, will need to move on to something else.

Is there an option to consider BAT, seems to work well If you have HRD/TP53 mutations.

I believe BAT is useful for those with consistently low PSA levels.

PSA median is 44 in the Transformer trial, the requirement is that you are asymptomatic.

tango65 profile image
tango65

Did they do a liquid biopsy or a direct biopsy to study the genome, histology an IHC markers, to see if there are drugs which could be useful to control the cancer for a while? The Color test is a germline study and does not give you info about the genome of the cancer except for the germline mutations you have such as the BRCA.

I did have both Color and Foundation tests/analysis. Main results included BRCA2, PTEN loss, tmprss2, MSS and low tumor burden. That's how I got Olaparib, based on off-label use. Was on it for close to 2 years before it ran its course.

NWLiving profile image
NWLiving

Hey- you made it to FDA approval of Lu177! Let’s kick the can further down the rocky road.

Just have to find a facility that has it available. Unfortunately, my treatment facility doesn't have it yet.

KocoPr profile image
KocoPr in reply toHopingForTheBest1

Mass General just started its first lu177 today. At least that’s how I interpreted it from my MO today

NecessarilySo profile image
NecessarilySo

Just wondering, why don't you mention hormone therapy? It;s like you're beating all around the bush.

HopingForTheBest1 profile image
HopingForTheBest1 in reply toNecessarilySo

I have been on ADT since the beginning of my diagnosis.

NecessarilySo profile image
NecessarilySo

Okay, sorry I was not aware and could not see it anywhere. That would mean to me that you are experiencing HRMPC, hormone-resistant metastatic prostate cancer. because if it were hormone-sensitive, it would not grow rapidly. There is albiterone with prednisone for HRMPC I believe. Other than that, (as far as I know, and I am no expert) I would simply suggest that you use heat therapy. All cancer cells die when exposed to 106 degrees F. You might try hot showers, saunas, hot tubs, heating pads, etcetera. Also lycopenes are shown to slow growth of PC cells. I am currently investigating a supplement called Xanthohumol

Neces, this is interesting, all cancer cells die at 106 degrees F. He's working outside today installing fence in this heat, he should be cancer free after today! I would like to know how a mans PSA can continue to go down while there may be some new mets to the bones? (my husband) I am trying to understand if he is resistant or non resistant. We had scans last week and although some seem to have disappeared or stayed the same, others have shown up...you are all warriors and amazing with your will to keep going!

NecessarilySo profile image
NecessarilySo in reply to

Of course he may work outside in 106 degrees, but the body has an automatic cooling system that keeps body temperature at 98.6 through blood flow and respiration and sweat and just keeping out of the heat. The mets are below the surface and not heated easily. PSA only measures Prostate cell growth. A person can have other cancer in other places such as lung cancer or whatever, and those can metastasize as well. So as bleak as the truth may sound, cancer just puts out new cell growth regardless of how hard we fight it. There are dozens of types of prostate cancer also, so your husband may be different from each of us and what he goes through can be unique.

in reply toNecessarilySo

Neces, I really did not believe he would be cancer free after a hot day at work, I wish!!! I did find it interesting that it dies at 106 F. My husband and I are both new to this awful disease, we both have so much to learn. I find myself constantly on this site, reading all of your posts...learning every day! Thank you Neces for your reply!

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