My PSA After Radiation

[jfoesq]

For those who follow me-

Radiation of my largest tumor after 10 years of ADT (Lupron and Zytiga) appears to have been "successful". My PSA had steadily climbed the last year up to a high of .32 and the doubling time increase was a concern. PSMA scan indicated "activity" in only my largest tumor. It was radiated. 4 weeks thereafter, PSA dropped to .05. yesterday, 7 weeks after the radiation, my PSA is now <.05, which is as low as MSKCC measures. So, for now, I will continue with the ADT treatments.

[shuckymesh62]

AWESOME!

[Mischa1111111 in reply to shuckymesh62]

i 2nd that!! Congratulations!!!

[jfoesq in reply to Mischa1111111]

Thx. Best to you!

[jfoesq in reply to shuckymesh62]

Thx. Hoping for the best for you and everyone (including myself).

[Hidden]

Excellent. Wise choice to continue ADT. Don’t give the little bastards a chance.

GD

[dhccpa]

What's happening with your other Mets? Still visible but no uptake on PET?

[jfoesq in reply to dhccpa]

Exactly

[nonm]

10 years of Lupron and Abi, was the SE getting worse ? or settled at a level over time. Thx!

[jfoesq in reply to nonm]

Side effects remain the same for the most part. Although, I do believe my hot flashes have diminished in frequency. I think I only get them about once a day now- usually after I eat dinner.

[Hippomike]

Great result. If you don’t mind me asking who is your doctor at MSK?

[jfoesq]

Dr, Dana Rathkoph

[Mw921000000]

My dad is also a patient at MSKCC with the same diagnosis. Congrats on doing so well in your journey, I pray my dad has the same success. Have you ever done chemo? My dad has been on lupron, Zytiga, and prednisone. He was diagnosed in January. We haven’t done chemo yet. I am hoping he can just stay on hormone therapy for as long as possible

[jfoesq]

Chemo was NOT recommended as an initial treatment back when I was diagnosed in 2012.My understanding is that based on more recent studies- Triplet treatment is the way to go, as long as one is in a healthy enough status to undergo them.

Obviously- you should confirm what I believe with your MO or with others on this site- especially with TallAllen, who I have great respect for after reading 100s of his posts that usually have links to studies that support his statements.

[BFOFARMO]

Congratulations on the great news!! May I ask where the active tumor was located?

[jfoesq in reply to BFOFARMO]

Left acetabulum (hip)

[20PeteG16]

Thank you for the post, very encouraging!From April till 15 August I participated in a clinical trial with Opaganib while on Zytiga at the Medical University of SC. PSA increased from 3.65 to over 150. Last week I returned to my local oncologist who ordered Xtandi in the mean time I was referred to our local radiation oncologist who began a ten day course of focal radiation on the two confirmed bone cancers. I pray I have the good fortune you have in controlling the pain (without oxycodone) and return to "normal" lab values.PeteG

[jfoesq in reply to 20PeteG16]

Hoping the best for you!

[Seasid in reply to 20PeteG16]

I believe you should try chemotherapy. If you have side effects you could always stop it. After the chemo Xtandi may work better.

[jfoesq in reply to Seasid]

I appreciate your trying to help but I am confused.Why should I try chemo if the science doesn't support me doing so. Can you refer me to any studies supporting your suggestion? I am not aware of any that do.Just because triplet therapy which includes chemo is the SOC NOW (but not when I was diagnosed) for NEWLY diagnosed metPC patients, doesn't mean it is appropriate for people who have basically been on Lupron, prednisone and Zytiga for 10 years.

Am I missing something?

Thx!

[Seasid in reply to jfoesq]

I am sorry, I mixed up your profile.

[Seasid in reply to jfoesq]

I thought I am replying to the 20PeteG16. It happened to me before. I believe that he should try chemotherapy before changing to Xtandi from Abiraterone. Abiraterone failed to him.

Usually after chemotherapy you could retry Abi or Enza.

If he has a high PSA maybe the best would be to do the liquid biopsy and see what are the actionable mutations. Maybe Olaparib or Keytruda will work.

That is the problem replying here as we don't know all the details and we are replying blindly in a certain way. If my PSA would rise to 150 I would personally consider chemotherapy ecpetially with bone pain. If nothing else try chemotherapy and hope for the miracle. At least one or two cycles maybe even four cycles up to 6 cycles and see what will happen to the pain and the PSA. After at least four cycles I would try Xtandi.

I am not talking here about you. Sorry but it was definitely a misunderstanding.

[jfoesq in reply to Seasid]

No problem.

[TJGuy]

Great!! LabCorp ultrasenitive PSA test goes to <0.006 Get that test going forward.

[jfoesq in reply to TJGuy]

Thx, but MSKCC doesn’t see any value in testing beyond the hundredths point- nor do I. What benefit do you see from doing that?