Ruh Roh!! Now what? PSA increased on Zytiga

[Keeper70]

We just saw MO on Friday and PSA came back .4 that’s double from November 3 at . 2 , My husband has been on Zytiga for three weeks.. We really thought PSA would go down maybe it takes more time he’s freaking out any help on this would be greatly appreciated! Thx

[Tall_Allen]

Pluvicto, if PSMA-avid

[Keeper70 in reply to Tall_Allen]

shouldn’t we wait a bit longer to see if Abi works? Yes to PSMA avid

[Tall_Allen in reply to Keeper70]

I checked the requirements- I was wrong. You would have to wait until his PSA increases to 2.0 or new bone mets anyway.

[Keeper70 in reply to Tall_Allen]

Thank you TA , I always respect your knowledge and experience in helping others,

[Lizardskin in reply to Keeper70]

thanks TA same question

[Keeper70]

that’s my thought too, thank you,

[tango65]

Did he have a PSMA PET/CT? What were the findings?

[noahware]

One increase is not a trend. In absolute terms, PSA is still quite low. See what the next reading or two brings.

It's a marathon, not a sprint. Tell hubby to slow down his huffing and puffing, he's going to wear himself out right away! (I know, easier said than done.) Here's hoping for the best on the next labs.

[Keeper70 in reply to noahware]

thank you, you are correct, easier said than done😜, doubling time was 3 months, now it doubled in one month, let’s hope Abi does its job as many have had many years successes with Zytiga

[anony2020]

Dont worry about little fluctuations. So they say. 😃

[Proflac]

Hi. Not advice but just some info from a sample of one. My husbands PSA has bounced up and down on the same meds (ADT plus zytiga/pred) between .28 to .4 to.8 and back to.2 over the last year or so. Best wishes.

[Keeper70 in reply to Proflac]

Thank you,, good to know. hope your husband continues to do well...

[rfgh20]

My concern some high grade tumors are so anaplastic they produce little PSA. I had 4 hot spots on PSMA scan with PSA only 0.2. Still not sure how these are followed.

[MateoBeach]

Perhaps get testosterone total and free along with PSA at next check to confirm it should be very low with Zytiga and ADT.

[slpdvmmd]

I think you can wait to meet US insurance requirements or be proactive by going elsewhere to get a PSMA scan. 2.0 is a ridiculous standard that limits care and is based on data from late stage disease patient cohort studies. My PSMA PET/CT was positive at lower than two. I think there is no greater truth than that told to me by a former colleague who is a well know prostate cancer researcher that "the USA is 20-30 years behind Germany and Australia with regard to imaging and radioligand therapy and given the bureaucratic/regulatory hurdles in this country we will never catch up". He strongly encouraged me to go overseas and I did.

[Spyder54]

Hi Keeper 70. Remain calm. Really. My PSA on 1000mg Abi/Zytiga-pred 5mg is never in a straight line. I just hit my low nadir at the 2 yr mark, and wrote down every PSA since Dx. Looks like a Secular Bear Stock Mkt graph. Zigs and Zags. Once I switched from Xtandi to Zytiga, it took 2-1/2 months until it started down again. So be positive. Eat your Cruciferous vegetables in abundance. Get cardio everyday. Weights 3x/wk. I drink High Ph water and High Ph wheatgrass based coffee to make the PCa uncomfortable, as Cancer thrives in an acidic enviro, and struggles in a high Ph enviro. Does it work? It all works, yet nothing out there yet is curative. Just extending until a cure, or more likely extended remission comes along! Mental strength and a good attitude seem to be a big part of the equation. Best to you and yours, Mike

[Keeper70 in reply to Spyder54]

thank you thank you thank you!! Those are all such great suggestions and calming influence and trying to manage all of the day to day struggles with this beast

he does try to exercise every day but adding some of those more cruciferous vegetables and high pH value beverages are worth a try! Best to use Spyder54 as well

[Seasid]

Do you plan to radiate the prostate?

[Keeper70 in reply to Seasid]

Hi Seasid, sorry took so long to reply to you , but yes after that PSMA Scan, We winter in Arizona and saw a radiation oncologist and started 44 treatments of Tomotherapy. He is post radiation four months now and PSA is 0.01, also he just dropped his Zytiga from 1000 mg to 500, Dropped 1 ,5 mg prednisone and his MO is now switching to six months Eligard instead of three months

He feels great the radiation oncologist gave him curative doses we will continue to follow up with him here in Minnesota as well as Arizona next winter