Rising PSA after Hormone Resistance

[Wyldhare22]

I am hoping for some insight. My husband is stage IV, mets all over his bones and lymphs. He had done Provenge and is half way thru Xofigo infusions.

They said PSA really can’t tell us anything now, but they still test it. It has gone from 11.27 in June to 60 this week. And now suddenly his oncologist wants to see him.

My question: Does PSA mean anything at this point? What would be his next best step? With his history with chemo (please see profile) would LU 177 be too dangerous to try? Are we out of options?

[Tall_Allen]

Xofigo usually doesn't affect PSA. Scans are a better indicator. Also, bone ALP.

He can't take Pluvicto for the next 6 months. It will also depend on his blood work at the time. I'd suggest both a PSMA PET scan and an FDG scan then.

[Wyldhare22 in reply to Tall_Allen]

What is an FDG scan?

[Tall_Allen in reply to Wyldhare22]

It is the most widely used PET scan. It shows glucose uptake by metastases.

[Wyldhare22]

I forgot, he did have genetic testing. Found two mutations, can use PARP inhibitors. ATM is in tumor itself ( not germline) - tumor agnostic treatment (PARP)