Non secreting PSA - How often will PC be monitored

[Ktm990jan]

Hi all,

my husband has just completed chemotherapy and he will have scans middle of January and will start radiotherapy beginning of February. My concern is how he will be monitored as he’s non secreting. His PSA was within normal limits when he was diagnosed with APC but did drop when treatment started but we were told this wouldn’t be used as an indicator of spread as can be a false reading while having treatment. Has anyone passed the stage of chemotherapy and radiotherapy, with treatment having had the desired effect, and have non secreting PSA, how were you managed and how often ?

also how long did you all manage after chemo and radiotherapy before it started to spread again and treatment needed to restart, although I realise hormones are lifelong

My very best wishes to you all

[DMohr011]

My PSA was 1.4 at time of DX and never higher. Gleason 9/10, grade 5. Low psa was due to cancer being a Ductal type, more aggressive. Genetic testing determined I have a broken gene, MSH2, a repair gene. My odds to get this dreaded disease was always 50%. Also due to this, made me eligible for Keytruda. This was early 2021 when treatments began.

I was monitored by quarterly scans. Had two PSMA scans this year and one round of CT scans this past October. Today my cancer is undetectable, and fingers crossed it will not return. Scans per 6months is the 2023 plan w/ quarterly blood work up. With my genetics and ductal form, this beast most likely will return, but for me, round 1 goes to the patient!

I wish you the best. This beast can be beaten or seriously beaten down.

[Tall_Allen]

Scans will be used to monitor progression.

[MateoBeach]

I don’t see that you have confirmed non-secreting type. Not yet anyway. Good that the chemo is done and now going for prostate and pelvic node fields RT. That’s the best shot. After that he can follow PSA along with scans, including PSMA scan if PSA is above 0.25 or so. If it does suggest non-secreting likely, then you can also follow CTC counts (circulating tumor cells in blood) and cell free DNA for genetic mapping such as Guardant360.

[Teacherdude72]

Forgive this question. Still learning after 8yrs with G9.What is non secreting PSA?

[mdiaz76 in reply to Teacherdude72]

generally different aggressive subsets of PC do not secrete PSA so while PSA may be low there may be high burden on bones and visceral so there are other markers/scans used to manage it

[Teacherdude72 in reply to mdiaz76]

So what testing measures this?

[Teacherdude72 in reply to mdiaz76]

This helps me feel better: Types of prostate cancer that don’t raise PSA are EXTREMELY rare. The common or garden variety of prostate cancer, adenocarcinoma, does raise PSA.

[Jparker4]

Hi Kim I had 47 treatments of radiotherapy, the process was painless. After the daily treatments I would take a protein shake , black seed oil to replenish my energy. After about 6/8 months of recovery the numbers continue to drop. The key is patience, a healthy life style. I went vegan , things started to change for me for the better. My Gleason score from the beginning was 24, now .-1.5