How to interpret PSA results

[DDCD]

Hi there,

Happy Veterans’ Day. My husband and I have a question about interpreting his PSA results. When he was diagnosed in March 2022, his PSA was at 387, with mets throughout his lymph system. Since then he has been receiving Lupron, Zytiga (but discontinued a couple months in due to liver toxicity) and radiation to the prostate only. The PSA has dropped all the way down to .3 where it has remained over last two tests.

He has a CT scan scheduled for Dec 5 and then an appointment with his oncologist but we are wondering today how to interpret the .3 PSA. Does .3 mean a very low level of cancer growth ongoing?

His oncologist said several months ago that he will likely start him on Xtandi or similar, but hasn’t yet.

Thank you for your input!

Dana

[tango65]

I believe he had a very good response to ADT and zytiga. If he stopped zytiga for a couple of months, he could wait a few months to see what happens with the PSA or request a change to darolutamide which has less side effects than apalutamide and enzalutamide.

[DDCD in reply to tango65]

Thank you very much for your reply and suggestions.!

[Tall_Allen]

PSA 387-> 0.3 is excellent! I hope he tolerates Xtandi better than Zytiga.

[DDCD in reply to Tall_Allen]

thank you!

[Chrisbaird]

high dosage of zytiga ( 1000gm ) gave me liver toxicity after 3 months had 1 months off then started 500 gm PSA continues to lower

[DDCD in reply to Chrisbaird]

interesting, we will ask the oncologist about that. Thank you!

[HopingForTheBest1]

Scan results will provide a clearer picture, along with PSA.

[DDCD in reply to HopingForTheBest1]

thank you. As your online name says, we are hoping for the best.

[Fightinghard]

considering his prior sensitivity, talk with your MO about starting on 1/2 of full dose Xtandi. Several others on this site have said that cancer control was achieved with reduced dose, and reduced side effects

[DDCD in reply to Fightinghard]

thank you, we will certainly take that advice.

[SteveTheJ]

The goal is always "undetectable", which varies by tester but say less than 0.06. However, .3 sounds very good to me. PSA is an indirect measure of the cancer; the bone and CT scans are direct measures. Best wishes.

[DDCD in reply to SteveTheJ]

thank you, that’s what we were wondering about.