Zytiga/Abiraterone, 3 months in, no change in PSA, T is< 12, normal response??

[Keeper70]

Hello fellow warriors!

My husband has been in Zytiga for 3 months now, was hoping PSA would drop, still at .4

Should we expect this or wait to see March’s number., .4 is his highest he’s ever had

We are seeing a top rated RO here in AZ to get 2nd opinion on PSMA scan and he is CRPC. Thanks in advance

[Seasid]

Your husband is oligo metastatic and potentially curable. They have to radiate his Mets and prostate if it is possible. Contact a centre of excellence. For example Dana Farber cancer institute. You could at least ask Dana Farber Radiologist for second opinion.

You shouldn't miss this opportunity for the cure.

István

[Keeper70 in reply to Seasid]

Hey Seasid, thank you, I believe Dr Gordon Grado in Scottsdale would offer us some options, hope you are correct on curable,we were told by his MO it’s not, but that was at Dx, 4 years ago, lots of new treatments since just Chemo and Lupron, we all keep hoping and 🙏

[Seasid in reply to Keeper70]

That is correct. Now I have MRI Linac from Electa Unity locally where I live. It wasn't there 4 years ago. It is a high precision SBRT machine. Lots of changed since my diagnosis.

They should consider you on the case by case basis. I personally would still go to Dana Farber cancer institute if I could. They have a team. I personally believe that the most important is a team.

I should have a team, but I don't have it and that is very dangerous.

I should have an urologist, MO, RO and a neurologist and also a neurosurgeon in my team as a team, but I don't have it.

All this people competing with each other for job.

For example if you have an MO with a friend who is a urologist you will be most likely be referred to a urologist by your MO ones you will have difficulties to urinate. They will try to solve your problem with surgery.

The RO could kill your CRPC in your prostate with radiation so you don't have this problem, but your MO will not refer you to RO saying that Radiation will not extend your life according to STAMPEDE clinical trials.

I don't care (I am polimetastatic and not curable but still don't want to use catheter to urinate nor to develop total incontinence after surgery.

If you can go to the place where they have a team looking after you.

Treatment decisions are very important to extend your life. I can't advise you. I am not a doctor nor I am a centre of excellence like for example Dana Farber cancer institute is.

I wish you luck and that God is with you.

[cesces]

It's the trajectory and not the absolute value of the PSA that counts.

A stable 0.4 PSA is good news.

Something to celebrate.

[Keeper70 in reply to cesces]

Thank you for that, we will celebrate for now

[tango65]

If I understood correctly, his PSA started to increase in 2022 after chemo and ADT.

The cancer is mCRPC. He is on Zytiga and ADT at the present time.

His PSA is stable around 0.4.

I believe that nothing should be done until there is evidence of radiographic progression of the cancer. It could be a good idea to get a PSMA PET/CT to follow the cancer evolution.

You could request Provenge a vaccine offering a survival advantage and discuss having a direct biopsy if there is evidence of new metastases.

[Keeper70 in reply to tango65]

Hi Tango65

He did have a PSMA scan in November , But it was so new at the time, I don’t think they were able to really interpret the results adequately enough which is why were seeing a second opinion RO here in AZ. Trying to see if radiation is recommended at this time

[tango65 in reply to Keeper70]

What did the PET/CT show?

[gsun]

Sounds like he is not CRPC but CSPC because his PSA is stable on ADT+ABI. A stable PSA of .4 is great.

[Keeper70 in reply to gsun]

I hope you are right, his PSA was never that high, so even for him at .4, it’s a worry

[Painterism1]

Hi, I've been getting an injection of elegard ever 3 months, and have been taking zytiga and prednisone for just over 2 years. I'm about to go on intermittent treatment. My PSA started out at 111 and is now .008, and my 3 metastases have shrunk to undetectable range. Keep it up. Hormone therapy works.

[Keeper70 in reply to Painterism1]

What do you mean intermittent treatment?

That is wonderful news that is working so well for you hope it continues

[oilcan4]

My husband was on same for 6 months and it did not reduce his PSA. He then started Xtandi and it also did nothing.

[Nfler]

You may also want to incorporate ivermectin in your regiment as it does wonders in reducing psa as well as making the Pca sensitive again after it becomes crpc. It’s been used billions of times to treat other diseases and Is very safe n well tolerated… good luck