PSA increase on Lupron and Zytiga

[SimplyT]

I have been on lupron and Zytiga the last 14 months with psa under .01 until 11/8 when my psa test came in at 0.27. This is of great concern to me and I’m trying to make decisions on where to go from here. My bio gives greater details of my situation. Thanks.

[Tall_Allen]

You can try switching from prednisone to dexamethasone to extend the effectiveness of Zytiga. There is no need to change therapy until PSA reaches 2.0.

[SimplyT in reply to Tall_Allen]

Thanks Tall Allen. I understand from my onc that is successful in about 1/3 of patients for a brief time. Concerned that I’m soon to be considered mCRPC if not already. Thanks

[tango65]

I think the cancer is CRPC.

One should remember abiraterone is effective in treating mCRPC,. A PSA increase of the magnitude you had, when taking abiraterone indicates the cancer has been evolving to CRPC and abiraterone is failing to control the CR part of the cancer.

I hope using dexamethasone will help to control the cancer longer.

Best of luck,!!

[SimplyT in reply to tango65]

Thanks Tango! Me too.

[Irun]

Wait until the next PSA results and see what it is . I have been on zoladex and zytega for 6 years , PSA 0.11 pretty much all that time then 0.22 then 0.25 , then ………. Just as I was about to start dexamethadone……………0.25……… so staying on prednisone for now .

I was always under the illusion that PSA once increasing had a standard increasing trajectory ie 2,4,8,16 etc but clearly that’s wrong .

My onco said it makes sense to hold back using dexamethadone for as bit longer .

What do I know but that’s where I am . , next PSA in 2 weeks so will see if it’s still 0.25

[SimplyT in reply to Irun]

Thanks for your reply. You are an inspiration and I have read your book. Former runner and triathlete here. I have hoped and prayed that I would have the success you have experienced with Abi. Best of luck to you!

[Irun]

fingers crossed for you but whatever happens to you , me and all our fellow brothers , make the most of every day as we will never have them again .