How fast should your PSA drop after the first ADT treatment.

[Bo1948]

My husband has stage 4. It is in his lungs, ribs, shoulder and spine. Plus a lot of the lymph nodes. No pain except when he broke his ribs just lying on his stomach.

That is healing without the palliative radiation.

How fast should his PSA drop. How will we know if this is working.

I know this treatment is to slow this down and the out look is three years or so if he is responding to this.

This is all new as of March this year so not even sure of questions to ask.

He will not do any radiation or Chemo except agreed to the palliative bone radiation for pain.

[GP24]

Your husband has high-risk prostate cancer. Standard hormone therapy should no longer be used in this situation. The best results are provided by the triplet therapy.

cancertherapyadvisor.com/ho...

[Hidden in reply to GP24]

When did the SOC change for High Risk? I was diagnosed in May 2019 with "High Risk" Metastatic Prostate Cancer with widespread bony metastasis, innumerable lung masses, and lymph involvement, stated immediately on ADT then added Xgeva, Zytiga and Prednisone, and that's been my only treatment ever since. 629 psa at diag, with Gleason 4+5=9 in nearly every core sample. It was debilitating bone pain that sent me to the Doctor initially.

[Bo1948 in reply to Hidden]

They say they don't need to do biopsy so I don't have a Gleason score. He is on Zytiga + prednisone

[meowlicious99]

It should start dropping within a few weeks. However, different people have different timelines of when it will reach the nadir. Time to nadir has some prognostic value ( you might be able to find references for this in search in this forum posts) .

[Tall_Allen]

Chemo and abiraterone with his ADT will stop the pain better than ADT alone. If he had Lupron or Eligard with Casodex, it can take a couple of months. Firmagon is faster.

[Bo1948]

We were told that the only option we have is the the ADT hormone shot every six months plus a pill (sorry forgot name) than prednisone to help with side effects of the pill. There is palliative radiation to the bones when needed for pain. But it is to wide spread for radiation or Chemo.

our hope is to slow it down.

His PSA was over 200. With his shot last month I wanted to know how low should his PSA be if it's working.

Also I'm sure I will have questions as what were people side effects other than hot flashes.

[Hidden in reply to Bo1948]

Then Follow the pros advice . Good luck to you both! 🙏❤️

[Hidden in reply to Bo1948]

We have members here that have started off with Psa> 1600 or more . Some have low Psa pc that is aggressive as hec. I’ve been <. 1 to date . I have all of the side eff3cts from no t . I did an orchiectomy 2017 so no t for me unless I inject it . My Docs say no way ! Take care 🙏❤️

[lcfcpolo]

Sorry that your husband has joined this club and well done for supporting him. The main thing is a continuous PSA drop each time your husband is tested down to a very low nadir, ideally below 2. The pill you mention is likely to be Abiraterone (Zytiga). In the past 12 months the latest research has shown that triplet therapy of ADT, Abiraterone or possibly Darolutamide and chemotherapy achieves the best outcome. Others on here are positive about having the chemotherapy earlier whilst you are stronger, if this is offered.

Also if possible request a biopsy and / or a blood draw to check if any mutations present such as BRCA2 or MSI-high etc. If these are present then it can open up new options.

Finally consider as second line treatments LU177 (Pluvicto), possibly with AC225 or look into J591. These treatments are available in the US of A but the Oncologists are also experienced with these treatments in Germany / Australia / India / Turkey / Azerbaijan if you can travel and self pay.

There is plenty to think about but you can search this site for many older threads on the above treatments. Please take a deep breath and do look after yourself as well.

[Hidden]

All treatments for stage #4 pc are considered palliative . There is No known cure . The best is a long term remission . Yet some have been here for 25 yrs past a #4 dx . It is rare . There is no respit until he gets a clear status . Even then we all ‘now it comes back someday.. we buy time if we are lucky .. Keep asking questions here.. It can be tmi at first . There really is no one clear path for all . I’ve thrown a lot of spaghetti against the wall . Do any thing to comfort him along the way . Compassion is great . Stay strong yourself in order to lead him through this ! ❤️🙏

[Brianne07]

Hi i am 73 reasonably fit .Had PSA of 389 now down down 0.08 to 0.06 for the past 3 months .Started Hormone therapy straight away followed by 6 rounds of chemo .Self inject firmagon ( hormone injection )once a month.Will follow up with Zytiga maybe in six months time .Listen to tall Allen and a few other experts would need the triple therapy .Keep a watch on the spine in case of pressure on spinal cord .This happened to me in C4 where pressure was causing pain in neck arm and leg.Had it zapped with one round of radiation now no pain.

I am considering my self lucky at the moment with a very good response to these treatments,

best wishes

[Brianne07]

forgot to mention after chemo all bone mets have disappeared and tiny spot on lung .It never goes entirely away.Regards Brian