Recent CT and PSMA pet scans show mild progression of activity in right superior paratracheal node ( SUV Max 3.2 in march 2023 vs SUV max 2.1 in june 2021) and right Hilar node SUV max 5.5 in March 2023 vs SUV Max 4.6 in June 2022)
what can or should be done about this?
Note my PSA has risen from 0.27 in November to .49 in April
I started Xtandi in June 2022 when my PSA was 0.69 and it quickly dropped to 0.40 in July
but has slowly but steadly climbed back up
Is the rise in PSA a result of this mild progression of disease in the lymph nodes or resistance to Xtandi
Back in 2021 I had SBRT to mets on my L1 T9 and T19 vertebrae and they are stable
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Ian996
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I don't think that focusing on visible metastases at this point does anything to benefit you. Systemic treatment gets what you can't see as well as what you can see.
My PSA is also rising slowly, but should not necessarily be considered failure until it gets close to 2.0. As a next step, consider chemo. Another possibility is a PARP inhibitor like olaparib, if you have a BRCA gene in your tumor tissue.
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