My Small PCa Cells Don't Produce PSA

[Bandit99]

Hi All,

Anyone here have these PCa cells and experience in treating them?

Bio/history summary :

- Dx Gleason 8 seven years ago

- Prostate tumour metastasis to seminal vesicules and pelvic lymph nodes

- PSA from about 150 to undetectable after ADT, enzalutamide , and 6 x docetaxal

Now

- March scans showed progression so enzalutamide stopped

- 7 cm tumour on hip, and others on other pelvic bones, numerous tumours in lungs

- 5 x radiation to hip and prostate

- completed 4 of 10 more docetaxal

Result: hip tumor slightly shrunk but new and bigger ones on hip wing; lung mets doubled in numbers and some tripled in size.

- PSA hovering between 0.3 and 0.6.

MO appointment coming in up with a big question in my mind: continue with chemo or not? My QOL is approaching the tipping point. I'm a warrior but am not going to fight a losing battle and suffer with tons of pain in many places.

Best Wishes to all on this forum.

[Benkaymel]

I have no suggestions for treatment but fear I might be in a similar situation to you. My PSA has been consistently dropping from 13 at Dx last year to currently 0.05 however, my bone tumours are not shrinking and the lymph nodes are slightly increasing on scans so I am interested in seeing what answers come up for you.

Hoping for the best for you.

[NickJoy]

I often come across this researcher from Canada in relation to small cell cancer. Her team has developed a drug she thinks will combat it but it doesn't appear to have gone to trial yet. Would it be worth contacting her to see if they are planning a trial soon?prostatecentre.com/about-us...

[Bandit99 in reply to NickJoy]

Many thanks!

[NickJoy in reply to Bandit99]

You are welcome. Best of luck.

[Hidden]

"PSA hovering between 0.3 and 0.6."

That's PCa producing PSA.

I was at 0.4, and showed a pretty large lymph node!!!

[Tall_Allen]

You have a mixed type. I think there is a carboplatin shortage just now, but add it if you can get it.

Here are some clinical trials:

prostatecancer.news/2016/12...

[cesces]

If you have small cell or "mixed type" as TA suggests, it means the cancer has substantially picked up it's tempo and you need to pick up yours.Start scheduling second opinions with small cell specialists and get them in place today for tomorrow.

Schedule them in Canada and EU to enable access to the carbo plantan that TA recommended you consider.

You have now lost the luxury of leisurely decision cycles that you have had until now.

It's officially no longer business as usual for your decision making tempo.

[Bandit99 in reply to cesces]

Thanks. My MO said I have 3 to 6 months unless I do treatment, and then put me on ten cycles of Docetaxal. I've done 4 and find out now small cell PCa seems to be unaffected by this treatment, as demonstrated by advancement of lung mets. Thanks again for your warning. I'll be seeing the MO on Thursday.

[anonymoose2]

Regarding the enzalutamide failure have you been taking the full dose 160mg or half dose 80mg. ?

[Bandit99 in reply to anonymoose2]

Thanks. I was taking 120mg. 160 seemed to be giving me brain fog but am not sure that wasn't caused by the chemo. 😊

[anonymoose2 in reply to Bandit99]

Thx 👍

[chips1942]

Hi Bandit, Our PCa experience, at least regarding lung Mets are very similar. Based on my scans, it appears that some nodules in my lungs are responding to the Relugolix + Darolutimide while others continue to grow. PSA is low 0.05 - 0.07. I’ve currently completed 3 docetaxel infusions and will have a PSMA scan tomorrow to see if the Doce has had any impact on the growing nodules. I’ve already had a lobectomy to remove my left upper lung lobe. Also thinking forward to next treatments, my genomic testing showed that Keytruda might be appropriate based on my pdl1 result. Did your genomic tests show any indication of possible treatments? Best

[Bandit99]

Thanks. I'll be checking with my Medical Oncologist this week about genomic test results.

[Bandit99]

Major correction. My face is red but smiling. I had mistakenly concluded small cells and found out today they're ruled out per attached (if anyone knows what the désignations mean).

We're stopping Docetaxal because it's not stopping progress, moving to Cabazitaxel shortly. The accompanying meds remind me of the joke that some Ferraris come with a dozen automatic speeding tickets, and Cabazitaxel comes with an automatic prescription for Immodium. 😐

Best Wishes

[Bandit99]

Per message 27 Jul 21:15

Biopsy