PSA slooooowly rising.

[GreatDane1979]

Hi. To cut it short, I have Stage IV Pca.At diagnosis (Nov.2020) my PSA was 66.

Had a few sessions of chemo and Firmagon.

That was insufficient after a 4-5 months so Xtandi (2 tablets - half dose) was added.

My PSA went down to <0.10 for a couple of months. Then rose to 0.12 - the 0.14 and it's now 0.19. with some activity in 3 metastasis.

I've had activity in two metastasis on my scapula for a year.

Q; Switch medication to abirateron or other medication?

Treatment on the active metastasis?

I guess changing the Xtandi treatment from 2 to 4 pills makes no sense.

I do not have additional diagnosis information.

Maybe it's just me - the PSA is still low, but reality is that it as been doubled in 6 months ( from >0.10 to 0.19)

Thanks in advance

[Hidden]

What about zapping the few mets you have?

Have you performed a NGS, telling you which mutations the cancer have?

I am further down the road than you, now on BAT enjoying testesteron again. Has stabilized PSA around 2. Could be part of your treatment plan when you are defined as CRPC

[GreatDane1979 in reply to Hidden]

Yes - my thoughts exactly.Silencing the three active mets.

I will try to get the mutation info from my doc.

All the best

[Kaliber]

dunno …but the normal dose of Xtandi is 4X a day. Probably you should have started out that way, …but it wouldn’t hurt to try the full dose before you completely dismiss it. Xtandi , full dose, has been very effective for many here, including myself. Just IMHO, your medical team always knows best based n your circumstances, and should make the final recommendations for you.

❤️❤️❤️

[GreatDane1979 in reply to Kaliber]

Thanks. The reason I am only getting half dose was side effects which went away shortly after. I am not sure they went away due to Xtandi though.Could be Eligard or other reasons.

I will discuss with my doctor and try 4 tablets Xtandi if he agrees

Thanks

[Kaliber in reply to GreatDane1979]

❤️❤️❤️

[tango65]

If you have less than 3 mets, discuss having direct treatment with SBRT and see if it helps to control the PSA and the radiology progression of the cancer.

Since the cancer is becoming mCRPC you could request treatment with Provenge, a vaccine proven to prolong life.

[GreatDane1979 in reply to tango65]

I do have more mets (6-7) but they are not active at the moment.SBRT on the mets sounds like the way to go.

I will discuss Provenge with my onc.

Thanks

[GreatDane1979]

Doctors conclusion as of today;

Going from 2 to three 3 Xtandi tablets and see how I cope with the side effects.

SRBT on my two mets. 10 sessions low dose instead of 3 sessions high dose.

Let's see if that works 👍