After being on Apalutamide, Lupron, & Xgeva, since April of 2022, & PSA drop from 7.3 (extensive bone mets.) & a drop to 0.1 (for 2 mons.), PSA rose to 0.6 over 3 mon. w/o lab work because doing so well. So, don't know exactly when it started to rise but the rate of increase is geometric!
MO wanted PSMA PET scan to see what's going on & possible treatment change. Had on 1/17 & following results, in brief:
The majority of the lesions seen on 4/22 exam (just before I started Apalutamide, Lupron) have resolved or markedly diminished in uptake. However, there are several new foci of uptake. Overall, in conjunction with the PSA curve, this likely reflects interval beneficial treatment response after 4/22 exam and now developingrelapse/treatment insufficiency.
MO hinted already at Chemo next in my visit with the 0.6 results. He would like to go Pluvicto, because better than Chemo & available in St. Louis region (I live just West) at 2 locations but must fail Chemo first per SOC!
Brief history: See bio for more:
DX & RALP 2017 (Stage IV pT3b, pN1) GS 9 , started Lupron 2017, IMRT/IGRT 2018.
Stopped Lupron after 2.5 yrs.
11/21 PSA 0.4, (1 lesion, Oligometastatic). Cyberknifed.
4/22 PSA 7.3. Started Apalutamide, Lupron & Xgeva. And here I am. See MO 2/1/23.
Any thoughts, please, Warriors?