Greetings from Sweden

[tasmanien13]

Hello ,

I am now writing because apparently my husbands PSA have risen during Adt-treatment. He has had Trelstar injections for 2 years now and PSA in August was zero, but now apparently around 2 checked by his GP. He has an appointment with his specialist in February. He feels fine without any pain and is exercising a lot. Can PSA bounce during ADT?

So if he already is castrateresistant should he have chemo? I am so worried again and hoping for advice from this group with so much knowledge and kindness.

All the best to you all!

[lcfcpolo]

The doubling time of his PSA is important here. If he has had only 1 check since August, then it is difficult to see a trend. Is your husband able to get monthly PSA checks from now onwards. Maybe ask for another check immediately as well to see if that is still 2. If it is, then in addition or instead of chemotherapy, you can also discuss with your MO taking Enzalutamide, Abiraterone or Darolutimide. Maybe request new scans as well if your husband has not had a scan recently. Good luck.

[tasmanien13 in reply to lcfcpolo]

Thank you for taking time to answer!I will try to get a new psatest and ask för additional treatment. I was thinking of triplet therapy, could that be suitable now?

All the best to you!

[GP24 in reply to tasmanien13]

The trial of the triplet therapy was done for newly diagnosed, metastatic PCa patients. I think your husband just needs Abiraterone, Enzalutamide, Apalutamide or Darolutamide.

[tasmanien13 in reply to GP24]

Thank you GP24! Then we will ask for this addition to his ADT. Are there bad adverse effects? Are they similar in effects? Sorry for all the questions...Best wishes

[GP24 in reply to tasmanien13]

They do have side effects but less than a chemo. All have about the same effectiveness against PCa. Darolutamide has the lowest side effects apparently.

[tasmanien13 in reply to GP24]

Thanks again GP24

[6357axbz in reply to tasmanien13]

I had zero additional SEs when I added abiraterone to my lupron

[davidw777 in reply to 6357axbz]

Same for me - adding abiraterone didn't impact my QoL.

[tasmanien13 in reply to 6357axbz]

Thank you, gives me som hopeFor how long did it work for you?

[Tall_Allen]

No, PSA does not bounce during ADT. He should have a PSMA PET/CT scan to confirm.

[tasmanien13 in reply to Tall_Allen]

Thanks,TA! Do you still add one of the above mentioned drug even if the scan is clear? No chemo? My husband has no adverse effects from Trelstar at all, but I am afraid that another drog will add problems with his heart , he has high blood pressure and 2 stints.Worried wife

[Tall_Allen in reply to tasmanien13]

You don't have his diagnosis and treatments in your profile, so I am unable to answer your question.

[tasmanien13]

He hade RP in 2011 with a PSA of 32. Clean margins, no lymphnode involvment. Then RT in 2013 and clear scans a few years later. Started Trelstar 2years ago and PSA went undetectable. Holding until , now coming up to 2.

[MateoBeach]

GP24 and T_A are giving good advice. He is probably now castrate resistant. Repeat PSA will confirm. PSMA PET scan can show where recurrence is located and indicate if Radiation Therapy is able to target it or not ( if more widely metastatic). Abiraterone is probably most preferred, though enzalutamide or darolutamide also good for addition to ADT when castrate resistant. Would hold off on docetaxel chemo at this juncture.

[tasmanien13 in reply to MateoBeach]

My worries now is if my husband now is entering his last phase of this or if it is possible to add more years with added ADT treatment? Right now I am so scared that I have to take tranquilizer. Thank you all for taking, time to reply, all the best🙏

[treedown in reply to MateoBeach]

Why is AA preferred. I personally am not sure I like the addition of the steroid. One of the questions I was asked prior do my DEXa scan was have I been on steroids for a long time. I know the amt is small but I wonder if I can get the same effect with Daralutamide , then it might be a better choice. Enzutamide concerns me as so many on this forumnhave bad SEs from it.

[gsun]

BAT

[tasmanien13]

Thank you Mateo, but can I ask gsun what BAT is?

[exeinoo in reply to tasmanien13]

Experimental. In trials but is not SOC yet. Many MOs are performing it.

Might reverse CRPC. Might increase effectiveness of concurrent therapies and might improve efficacy of post use of Xtandi. Small trials show all these things.

pubmed.ncbi.nlm.nih.gov/353...

[Rev214]

While he has a notable PSA of 2.0, it would be wise to ask for a PMSA Pet scan as it will show all locations harboring PMSA prostate tissue. It can reveal cancer mets up to, 7 years earlier than just Bone and CT Scans. Then you will have better info to plan the future.

[tasmanien13 in reply to Rev214]

I understand he needs a scan now. Is it possible to radiate mets, he already had radiation to the prostate? So thankful for all advice, you mention the future, something I cannot see right now from my dark place. All the best to you

[tasmanien13]

Can I ask if it it wise to take Melatonin at night and also Sulphurafane, as Broccomax?

My thoughts are if these two interact with Trelstar in a negative way?

Best wishes!

[exeinoo in reply to tasmanien13]

I've never heard of any interactions.