First PSA result after treatment

[ThisIsForMyDad]

My dads original PSA was 39 before treatment. He is stage 4 (4+3 Gleason) and cancer spread to some local lymph nodes and one intra-abdoninal lymph node, making it stage VI. No bone spread.

My father completed 44 rounds of radiation treatment 1 month ago. A very arduous journey of exhaustion. Had to take. 10 day break which is rare.

Today we received his first PSA results since he recieved his first Eligard shot 6 months ago, and started Apalutimde 1 month ago. It’s 0.50. Should it be lower? Closer to .01? Should we worry that treatment won’t work for very long?

Any insight would be so helpful!

Also he lost 35 pounds since February— bad diarrhea from the intraabdominal lymph node radiation. Lost his appetite but finally getting it back. Is that normal?

Thank you for your support and any answers are welcome!

[meowlicious99]

> It’s 0.50. Should it be lower? Closer to .01?

don't think there is a number that it needs to be. ofcourse lower is better. Its still going down so thats good and all that matters.

> Should we worry that treatment won’t work for very long?

No. Infact its the opposite. Slow decline has better prognosis. You can search this forum for references.

[ThisIsForMyDad in reply to meowlicious99]

Thank you so much for this info. I’ll research this community like you suggested. Appreciate it!

[tango65]

Consider to discuss triple therapy with ADT plus docetaxel and zytiga or darolutamide.Triple therapy seems to be the treatment most indicated in de novo metastatic hormone sensitive PC.

[Hidden]

Is his prostate still in his body?

[ThisIsForMyDad in reply to Hidden]

Yes, he still has his prostate. They wouldn’t operate since it spread to a lymph node in his abdomen, so he had 44 treatments of radiation to the prostate and lymph node but unfortunately no surgery.

[Hidden in reply to ThisIsForMyDad]

then anything below 0.1 is good.

[ThisIsForMyDad in reply to Hidden]

Unfortunately it’s 0.5, and after very aggressive radiation. Was hoping closer to 0.1 but grateful it at least responded. Thank you for your response. It is most appreciated.

[Hidden in reply to ThisIsForMyDad]

my mistake. Didn’t catch the decimal point

[London441]

I can understand you blaming the radiation for his exhaustion, but at the point radiation began he had been on Eligard for 5 months and apalutamide added as well. Does he exercise? Fatigue is much more common from the Eligard than radiation, lessened dramatically with exercise, and made worse without it.

[survivor73]

I have a similar situation but just had the Eligard injection one month ago after a PET - CT scan showed local met from Prostate to a lymph Node and a small sign showing on vertabra. I will probably have Proton Therapy Treatment in a few more months as do not want to be on Hormone Therapy injections for more time than necessary - the effectiveness can wear off after time and the tumours adapt and find ways to feed off other things!

[babychi]

To achieve a longer life (and more travel) we’ve taken steps to eat really clean, cease alcohol, walk 4-6 kms daily and complete weight bearing exercise daily, a little organic meat and chicken, lots of veges, limit eggs. He is doing great and we feel the effort is worth it. Otherwise treatment, we feel, might have been in vain. Changing our lifestyle was something we recognised might be a necessity.

[Woodstock82]

Don't be impatient. Watch the PSA trend. Lower is good, but don't be alarmed by an occasional small spike. I've chatted with several guys whose PSA took years to reach nadir after radiation.

[VLBIV in reply to Woodstock82]

I completely agree with Woodstock82. What matters for all of us is the trend, not one measurement. We're all in it for the long term (whether we like it or not), so try not to get tense about one number and instead focus on long term trends. Staying positive is extremely important! I wish you the best.

[j-o-h-n]

to ThisIsForMyDad, His Age? His Location? Where being Treated? Answers are voluntary but helps him and us. If answered, good idea to update his bio. My Regards to him and to all involved in his health. Keep Posting....

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 04/19/2023 9:58 PM DST

[ThisIsForMyDad in reply to j-o-h-n]

Bio updated! 72 year old male from Pennsylvania being treated at Lehigh Valley Topper Cancer institute.

Retired from a physical, blue collar job in 2020. Was in great shape with lots of muscle! Lost 30 lbs during his 44 rounds of radiation.

Thank you for your response and guidance.

[ThisIsForMyDad]

they said this was also a low volume Desiree with only one area where it metastasized- infra abdominal lymph node. I asked for chemo up front in addition to the Eligard, Erleda, and radiation but they kept saying no bc it was low volume. But wouldn’t you want to kill whatever micro metastasis there are before they can get bigger? SO FRUSTERATED

[meowlicious99 in reply to ThisIsForMyDad]

would you mind add case history in your profile. Its hard to piece together info from posts.

ADT and second gen hormonal is indeed a systemic therapy

[TylexGP]

Here is my PSA History. Started ADT + Abi on 5/1/2022, HDR Brachy 7/24/2021, EBRT 25 sessions Sep 2021. Currently still on ADT+ Abi Current plan is to Stop at aprox 24 months pending results of Scans scheduled in July.

5/2021 10.48 ng/ml

6/2021 0.7 ng/ml

7/2021 0.35ng/ml

8/2021 0.45 ng/ml

9/2021 0.2 ng/ml

10/2021 0.17 ng/ml

11/2021 0.13 ng/ml

12/2021 0.11 ng/ml

1/2022 0.16 ng/ml

2/2022 0.13 ng/ml

3/2022 0.11 ng/ml

4/2022 0.13 ng/ml

5/2022 0.11 ng/ml

6/2022 0.08 ng/ml

9/2022 0.06 ng/ml

12/2022 0.08 ng/ml

3/2023 0.05 ng/ml

[ThisIsForMyDad in reply to TylexGP]

wow! Thank you so much for sharing this info. So you may stop ADT even diagnosed at stage 4? My dads oncologist said he could never stop ADT. I see a lot of oncologists recommend breaks and I’m thinking it might be time to consult another dr.

[TylexGP in reply to TylexGP]

I am stage T3b N1 M0 meaning I have locally advanced disease with one positive node in the pelvis. Though there are Stage 4 men that do get a break from ADT if PSA is low and stable overtime but that is a personal decision made in consultation with there MO. I am very anxious about what will happen when I come off ADT . I know my team will follow me very closely but its a double edge sword looking at the risk/benefit of stopping or staying on.