Erratic PSA on jevannta

[Muffin2019]

Started (cab) in September of 2022, on 3 month elgard, next one is February along with xgeva and my 9th infusion. This is my PSA history. 8/19/2022 - 49.8

9/13/2022 - 30.2 - first infusion - had the eligard and xgeva shots

10/5/2022 - 27.3

10/26/2022 - 26.0

11/16/2022 - 35.0 - freaked out, this was done at infusion

12/02/2022 - 25.7 - had my eligard and xgeva shots

12/23/2022 - 25.7

01/13/2023 - 24.4

01/18/2023 - 37.5 - before infusion

The next PSA test is 2/3/2023 5days before the 9th infusion and the infusion is 2/8/2023 along with the eligard and xgeva shots so the insurance will pay. My immune values were low that is why they did the blood work, the values rebounded for the infusion on 1/18. The question is why the increase both times in the PSA on 11/16 and on 1/18/ ? The infusions seem to be working with minimal side effects, anybody out there has had this happen or any thoughts on this sudden increase then drop, concerned. Plvitco would be next but want to get as much mileage from jevtanna, do not want to run out of options yet, last chemo was 2018, with lupron since then 1 year and half on Zigtea and 3 months on xtandi that failed . Last scan showed mass in bladder gone, nodes in lung and lymph nodes gone but still lesions on liver with a reduction of the largest lesion.

[EdBacon]

Based on your scans, it sounds like it's working. The fact your PSA is not going up steadily is also good. What was your doubling time before you started? I wouldn't read into to those fluctuations, just look at the overall trend.

Mine was doubling every 3 weeks and when I started Cabazitaxel, it didn't go down, but stopped going up at least. I probably would have kept milking the treatment had my results been like yours. And if you can tolerate the side effects of course. Like you say, get as much out of as you can before moving on. That's what I would do, but talk to your doctor about it.

[Muffin2019 in reply to EdBacon]

On 9/15/21 it was .8, on 11/10/21 was 1.0, on 1/28/22 it was 1.8, on 3/23/22 it was 4.4, on 4/13/22 it was 5.0, on5/13/22 it was 6.8, on 6/24/22 it was 13.3. I stared extandi in July, on 7/19/22 it was 21.3 and on 8/19/22 it was 49.8, it was then started the Jevannti. The xtandi did not work, before that I was on Zetia for a year and half. When it hit the 49.8 I requested to start the cab immediately due to the liver Mets and the bladder issues and the nodes which was in the CT scan, impanicked and was in for the fusion the next day at 9 am.

[EdBacon in reply to Muffin2019]

Your PSA doubled from 7/19 to 8/19 which is about the same time frame and PSA rises I had. So if Cabazitaxel wasn't working at all, your PSA would have roughly doubled again in a month and doubled again in another month, etc. I think it's safe to say it would be significantly higher than it is now. My PSA stalled after the first cycle, but started going up again only a little slower. For me it was pretty clear Cabazitaxel had stopped working. We did a couple more cycles because it was giving me pain relief and helping bridge the gap to Pluvicto. I was planning to do 10 cycles of chemo, but that didn't make any sense. In the end, I did 5.

[Muffin2019 in reply to EdBacon]

How are you doing, have not checked your posts lately ? I know you have very on cab much longer than I have and did it help thd liver Mets?

[EdBacon in reply to Muffin2019]

I didn't have any liver mets, mainly just bone from what they see on the scans.

[Muffin2019 in reply to EdBacon]

Sorry I thought you did, have you started plevicto and how are you doing with that, I hope it works and how about the side effects ?

[EdBacon in reply to Muffin2019]

Pluvicto will be on Jan 30. I just saw my doctor yesterday and he's treated 3 patients so far. Two of them had good PSA reductions, one went down to zero and another had hip pain like me, but lost his pain in 2 days. The third one is too soon to tell. Some had nausea but that was handled well with Zofran.

[Tall_Allen]

Dying cancer cells add PSA to the serum. That was good news. You are getting way too many PSA tests.

Don't worry about running out of options, treat the cancer as early as possible with whatever is available.

[Muffin2019 in reply to Tall_Allen]

Thank you, I will speak to tge oncologist at next follow up, I thought it was dying cancer cells myself which is good news. You are the best with rock solid advice, the PSA tests before the infusion I agree was not needed and will address with the oncologist, the last one was not supposed to include the PSA which I pointed out to the nurse but did no good, the only order was the CBC and the check on the white cell count due to low numbers 5 days ago so plan on addressing that at the next follow up 3 weeks from now. Thank you for receiving the stress, you rock.

[eddieboy52]

I took three, three-month injections of Eligard. It turned me into a weak, fat very grumpy old lady with depression. I stopped it. Will NEVER take it again. There are two pathways of this thing called "life".....quantity.....and quality......my PSA has increased from .04 to 1.1 and my disposition has improved from zero to 10!!!......I prefer QUALITY!!!

[Muffin2019 in reply to eddieboy52]

Been on eligard or lupron since 2018, gained about 20 pounds (was underweight ), not really side effects bothered me, I adjusted. I now have a shelf for my snacks, the hot flashes was intense but joked about it, better than the alternative. The side effects from this chemo is more intense but again better than the alternative called death.

[Muffin2019]

Got the head to toe bone scans and only found a fracture in the L2 vertabre, no Mets in the bones so the suspicious spot when the CT scan was done was that a false alarm. I do have osteoporosis and could have happened when I fell into the door while relocating one of the female cats. The bad news today is that my snuggle buddy black cat who will be16 this year had a cancerous lump on his front paw. It has gone into the bone and possibly a spot in his lung so surgery is out of question. The vet's recommendation is to watch for bleeding, difficulty in breathing and not eating then it is time to help him cross the rainbow bridge.