PSA fluctuations on docetaxel?

[PHnerd]

Hello all, is it normal for the PSA to increase and decrease while on docetaxel? Dad’s enrolled in a clinical trial and is receiving chemotherapy (docetaxel). His PSA was declining but suddenly increased to 1.26 two cycles/doses ago, and to 1.39 last cycle/dose. Wondering if this is indicating his cancer is becoming resistant to the chemo? (Note: this is his first time being on chemo as he’s never been on chemotherapy before and he has had castration-resistant PC for 11 years, metastasized to the pelvis in 2019. He’ll be on dose #7 of docetaxel as of tomorrow).

[spencoid2]

Just had a zoom with my favorite (Dr, Aggerwal of UCSF) onco today and asked the very same question. It seems that PSA while on chemo does not mean much, it can go up or down. After chemo and a waiting period it means more. if it goes up consistently (not just one test) indicating a trend it can indicate that the chemo was not successful. Unfortunately we have to be patient and not worry too much. If it works it works if not then it is time to try other treatments. I am having dose 8 in a couple of days and was hoping to see a decrease in PSA but I was told to not worry about it.

[joeguy in reply to spencoid2]

Im on 4th dose of Docetaxel and PSA has dropped after each infusion from 40 to 8 , but scans show no change in size or number of tumors…… I would have thought there was a direct relationship to PSA and tumor burden…… guess not

[PeteLG]

Yes a bit concerning is correct.My PSA has been increasing from single digit to over 400 in the last 12 months. I went from Zytiga to Xtandi to focal radiation for hip then back, and now finished 4th docetaxel. Last lab, PSA exceeded 500 just before oncologist left for west coast. Next week back to Medical University of SC and new MO. Labs at labCorp today.

Yes concerning, and looking for help at MUSC when urologist and oncologist after over 10 years both leave our small town. Replacements due in August.

God help us,