Chemotherapy yesterday, Labs before show PSA 6 pts higher…

[Shorehousejam]

My husband has sever plaque psoriasis was put on Otelza on Friday, 4 days before PSA test and Lab, LDH 190 to 235, PSA 0.20 to 0.26

See History:

Diagnosed

By PSA Score 942.40 on 07/06/2022

Advance Metastatic Prostate Cancer with Ductal subtype

with focal cribform architecture in carcinoma (it is rare, unfortunately aggressive)

4 cores out of 15 with another questionable core with necrosis and questionable atypical cells

Stage 4 Gleason 8 3 Lytic Lesions (unusual or rare)

CT Scan, Pylarify Pet Scan, Bone Scan,

3T 3D guided MRI with write over

07/15/2022 Transperineal Biopsy

Started Firmagon 7/6/2022

Zytiga with Prednisone 7/20/2022

and Docetaxel Chemotherapy on 08/11/2022

Ductal Prostate Cancer is

aggressive, it cannot be monitored by psa score alone.

As it can still spread by low non existing psa numbers.

However, his Medical Oncologist states my husband does expresse a lot of PSA.

PSA 942.40 7/6/2022 Started treatment

To 2.87 08/03/2022

To 1.07 08/11/2022 Started Chemotherapy

To 0.41 09/01/2022

To 0.34 09/13/2022 Testosterone <7

To 0.24 10/18/2022 Testosterone <7

To 0.20 11/08/2022 Testosterone <7

Started Otelza 11/26/2022

Up To 0.26 11/29/2022 Testosterone <7

Concern about rise in PSA, also on chemotherapy and had his 5th session yesterday…

The lab work was prior to chemotherapy

So, could the PSA test be skewed by the new immune suppressant Oztela / Ampremilast for his psoriasis?

[mperloe]

I'm uncertain that moving from 0.20 to 0.26 is a clinically significant rise. Ask your MO re likelihood of margin of error on testing.

[Tall_Allen]

That's not significant. In fact, if you can, get a PSA test where the lowest value is 0.1 (no extra decimal points)

[Shorehousejam in reply to Tall_Allen]

That’s from Cornell, of course we want the PSA to drop to .01 but unfortunately as stated it went up from .20 to .26 not happy, we are both concerned of the rise as insignificant as it appears, he has ductal with cribform features and it’s alarming to us, any rise in psa

This is cut/copy from the portal as Cornell reports the psa

Your ValueStandard RangeFlagProstate Specific Antigen

0.26 ng/mL<=3.99 ng/mL

As of February 2017, this test is performed on the Siemens Centaur using Chemiluminescent Immunoassay. Values obtained with different assay methods or kits cannot be used interchangeably. The results cannot be interpreted as absolute evidence of the presence or absence of malignant disease.

[Grandpa4 in reply to Tall_Allen]

Totally agree. The more sensitive tests can cause emotional trauma without adding information. My brother (we both have PCA) is on abiraterone and Lupron. His MO uses a very sensitive assay and his PSA came back as 0.02. This caused a lot of pain as he assumed resistance to abiraterone. So far it is just bouncing around below 0.07. Maybe it will go up soon but it is not helpful to know early.

[Seasid]

I am very happy that nobody from my family is following closely my prostate cancer journey.

They just ask how are you if even that. They may thought 4 years ago that I will die sooner but now after 4.5 years after my diagnosis they may say, oh well you live long.

I believe that your husband is doing well and that he is getting the best treatments and scans.

I didn't have any scan for almost 4 years and I am only on ADT Degarelix injections only. I had an early docytaxel chemotherapy 6 cycles and I had 15 plus bone mets in my spine.

Now I don't have any visible mets on my PSMA PET/CT.

My biggest concern now is that I am osteoporotic. I have to go to the endocrinologist for that.

I just finished radiation of my prostate and mu PSA dropped from 1.4 to 1.2.

[Concerned-wife in reply to Seasid]

your comment about family made me pause to think about how various family members and friends react. Thank you.

[Seasid in reply to Concerned-wife]

I don't want that they are preoccupied with my cancer. I am more than capable making decisions and happier if they don't interfere with my desissions.

I believe it would be unproductive and just unnecessary burden on them. I am so happy that I am not under guardianship and that I can make my own decisions without pressure from outside.

I see that I am probably the only one who is going to the doctor alone and I couldn't be happier.

Ok, my son is pushing me to exercise and that is ok. Otherwise even that is not necessary. I know what I can and can't.

[Grandpa4 in reply to Seasid]

every family is different. My brother and I share this journey. We find it helpful. We have someone who really understands to talk to.

[Seasid in reply to Grandpa4]

The problem is that only the person undergoing cancer treatment can understand himself.

So many years after talking to my friend who had a breast cancer and died I am still under stress.

I believe I could not properly understand her and I believe she was in a better position to make a decision for herself.

That is a reality.

[Grandpa4]

yes I agree it is hard or impossible to talk to someone not going through the same thing. My younger brother just happens to be going through the exact same illness only he is a couple of years ahead. I would not wish it on him but it has been great to have him by my side on the walk.

[SteveTheJ]

FWIW, I take Skyrizi and have never noticed any correspondence between psoriasis, nor medication, and the cancer. Best of luck.

[Shorehousejam in reply to SteveTheJ]

Hi, Do you have Advanced Metastatic Prostate Cancer? We are trying to find a medication for sever plague psoriasis, my husband was on Stelera and then Tremfya for years, his MO took him off because he didn’t want my husband on any suppressants….I found a study possibly going to trial that IL-23 inhibitors which Skyrizi is may be used for prostate cancer as an aide…see thisicr.ac.uk/news-archive/immu...

Tall_Allen any thoughts? We are desperate

[SteveTheJ in reply to Shorehousejam]

I have stage 4 prostate cancer, diagnosed in March 2020. Psoriasis started when I was a teenager. Currently I take Skyrizi for psoriasis; if it has an effect on the cancer, so much the better.

[Shorehousejam]

That’s great news, Thank you