PSA Rising While on ADT and Abiraterone

[Islandboy2021]

I started Abiraterone in November 2022 and my PSA was 3.83. Over the last few months it dropped to 2.71, 2.50 and then 3.02 and now 3.28.

Does this mean I am not responding to the Abiraterone any longer. I have only been on it for 3.5 months.

Am I doing something that is interfering with the drug.

I take the Abiraterone in the early morning and the prednisone at lunch. I do restricting eating and only eat at lunch and dinner.

Thanks

Rick

[Magnus1964]

Your PSA is still low. Don't stop your meds. If your PSA continues to rise then it might be time to move on to xtandi, if you haven't been on it already.

[Tall_Allen]

I don't think you are doing anything wrong, it is just your stoopid cancer. Will they let you have Pluvicto in Canada? Xofigo? Or consider combinations like these:

prostatecancer.news/2022/06...

prostatecancer.news/2021/02...

prostatecancer.news/2022/10... (maybe with cabazitaxel+carboplatin instead of docetaxel)

[Islandboy2021 in reply to Tall_Allen]

Thanks for the reply.

It would be nice to add something to the abiraterone and save the chemotherapy for later.

I have already had chemotherapy at the beginning of diagnosis.

[john4803 in reply to Islandboy2021]

Can't you qualify for Pluvicto after failing Chemo? That's the way it is in the US, I think?

[EdBacon]

If your PSA continues to rise, you can try switching steroids from Prednisone to Dexamethasone. That made a difference for me, gave me an extra year.

[slpdvmmd]

Did you get a PSMA PET/CT?

[Islandboy2021 in reply to slpdvmmd]

I haven’t had any scans for over a year. They won’t give me the PSMA PET scan.

I am waiting for a CT and MRI scans.

[slpdvmmd in reply to Islandboy2021]

Clearly PSMA PET/CT would be best as it would probably more clearly defined the lesion and also help determine if LU177 or other radioligand is a viable option. I was faced with a situation very similar to yours prior to approval of these modalities in the US other than on protocol. My CT and bone scan were read as negative and I was deemed a biochemical recurrence with no defined origin. PSMA PET/CT defined 3 sites and I was treated in Germany. I planned on retiring but have continued to work to off set care costs. Clearly finances can determine options but base on this forum Turkey still seems a reasonably priced alternative for both a scan and potential treatment. I wish you the best in your pursuit of care.