Low PSA, high metastasis, ready for chemo+

[Skifanatic]

I was first diagnosed in 2019 with Stage 3 PCa — although I had regular DREs and my PSA always hovered between 2.5 and 3.4. Now, after treatment, and PSA rising from undetectable to .4 and .5, my PSMA Pet scan shows that the cancer has metastasized pretty extensively. I’m under the care of Dr. Eugene Kwon @ Mayo Clinic, have begun Eligard and I’m set to begin next week Taxotere + Carboplatin to try to get this under control (will do three rounds, and then scan to gauge impact). Will take a 2nd gen ADT, but not sure yet which one Kwon will prescribe. Also, Lutetium 177 is very likely on the horizon. I was with another doc until last week who advised Eligard, plus Nubeqa and then Taxotere…the standard “triple therapy”but I didn’t feel he was throwing the proverbial kitchen sink at my disease which I think is warranted. After reviewing my history, Kwon suspects that my cancer was metastatic in 2019, and my doctors at that time should have ordered a PSMA Pet scan — that’s water under the bridge, but a good lesson for others (and me, perhaps too late) to drive one’s treatment and demand tests and imaging and follow one’s gut instincts. As we all know, we only have one chance to get this right and every wrong turn leads down a darker road. I’m hoping to see some light as I pursue my new treatments. I welcome your thoughts and advice as I move forward and will keep you posted on my progress. Wishing all of you on this site better health and good fortune!

[Hidden]

as my Research Professor Medical Oncologist told me in 2004, It mattered not which primary treatment you had. It was too late. You were probably metastatic when cancer was first diagnosed. It’s called micro-metastasis. The unseen and undetectable mutant cells that escape the prostate traveling through your vascular and lymphatic systems looking for a place to land and colonize...... now, what I wrote is highly debated.... however, I trust my guy who spent a career in academia researching and teaching new physicians in genitourlogical diseases.

GD

[mysticmini]

Also diagnosed with low PSA - a Turp surgery biopsy diagnosed Gleason 9, scans showed spread to pelvic lymph nodes. Lupron and Zytiga for 6 months, and then scans showed spread to cervical lymph nodes. Only 6 months to castrate resistant. Just finished 4th round of Chemo (Dox with Carboplatin) Scans after 3rd round showed resolved and smaller lymph nodes. Also have a consultation with Dr. Kwon for a second opinion in January after chemo is finished. Oncologist at MSK is suggesting radiation may be an option. Only 55, so ready to throw the kitchen sink at it. Tolerated chemo well.

[Skifanatic in reply to mysticmini]

Sounds like you’re making good progress, congratulations. I’m going this week for my second round of docetaxal + carboplatin, then will see Kwon in January after third treatment for blood work and PSMA Pet scans. I started quarterly Lupron shots in October and Nubeqa in mid-November. Hoping we can get this wily disease under control. I think that Lutetium 177 may be in my future, but waiting until we get a more clear picture in January. Fingers crossed!

[FormulaRob in reply to mysticmini]

You became castrate resistant in only 6 months? I didn’t think that was even possible but I am still learning. My father just started hormone treatment so I figured he has years before having to worry about becoming castrate resistant

No spread to bones for you either so I assume that you are extremely treatable ?

[mysticmini in reply to FormulaRob]

Yes, some men are lucky and can keep under control with ADT for years. Not so lucky here. No bone mets, just lymph nodes