PSA rising during triplet therapy. What to ask the oncologist?

[Sissel25]

Hello to this wonderfully helpful community, my dad's initial PSA was extremely high (3103), so I don't know what to expect. The treatment has been going for four months and a half since ADT (2 months and a half since Zytiga and Docetaxel was added).

He started ADT on December, Zytiga and Docetaxel two months later. He is at his third chemo dose, fourth tomorrow, and it went from 99.30 to 99.70 after the third dose. What should I ask the oncologist since instead of lowering or stabilizing it went slightly up?

ALK is lowering (631->552), LDH is increasing (200->251), CRP is also increasing (1.50->4.30).

Thank you, I'm putting the history below

____

Metastatic Prostate Cancer

PSA Nov.11/22: 3103

Given Firmagon on Dec.2/22 (240mg)

PSA Dec.28/22: 500

PSA Jan.24/23 : 600

Given Zytiga to take the same day after blood test

PSA Feb.02: 356

Started Docetaxel on Feb.02

PSA Feb.27: 121

PSA Mar.20: 99.30

PSA Apr.11: 99.70

We are at the third dose of chemo, fourth tomorrow

[Tall_Allen]

Discuss switching from docetaxel to cabazitaxel (maybe adding carboplatin too).

Discuss switching from abiraterone to darolutamide.

[Sissel25 in reply to Tall_Allen]

Thank you very much, does that mean that resistance is settling in, or that either Zytiga or Docetaxel had little to no effectiveness and were carried by one or the other?

[Tall_Allen in reply to Sissel25]

It means what you're doing is not working, so you have to try something else.

[GP24]

Maybe the PSA value gets lower again after the fourth cycle.

[tango65]

The PSA is stable, and much lower than initially. Let the treatment to continue and see what happens. If the PSA starts to increase then you could re-evaluate the situation.

[Sissel25 in reply to tango65]

Thank you, we will see with the oncologist

[Izzygirl1]

My husbands PSA spiked once during docetaxel treatments and then went back down. He is also on darolutimide and lupron. (Triple Therapy)

I hope your dad’s number is lower at his next blood test! 🙏

[Sissel25 in reply to Izzygirl1]

Thank you very much for the words of encouragement and I will pray the same for your husband.

[Lrv44221 in reply to Sissel25]

How nice thank you

[Izzygirl1 in reply to Sissel25]

thank you Sissel25. Prayers are always appreciated and I will be praying for your dad. 🙏

[Chubby42]

My PSA went up & took till the 4th cycle before it started to drop then came down quickly after that.Worth sticking with it, good luck.

[Gl448]

Were you able to ask your oncologist yet? Curious what he said?

[Sissel25 in reply to Gl448]

We're gonna keep sticking to the current treatment and see if it stabilizes for now