Progression

[NDJIM]

My Oncologist says that after 4+ years of ADT, I am showing signs of castrative resistance. He also said that I am currently Low volume, low PSA Oligmatistic. Can someone translate. I had a PSMA scan a couple of weeks ago and the Radiation Oncologist said that I had a positive response. Thanks in advance.

[6357axbz]

Did you ask your RO where the PSMA scan was positive?

[NDJIM in reply to 6357axbz]

Prostate L5 vertebrate and small spot on the sternum.

[Tall_Allen]

It just means that your PSA is rising and/or there are more or larger metastases detected in spite of using ADT. It is usually a signal that more meds are necessary. Oligometastatic means that 5 or fewer metastases were seen on imaging.

[j-o-h-n]

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

What does this message mean?

[MarkBC]

My cancer became resistant after 4+ years too. We added abiraterone and my PSA is now undetectable. We're hopeful for a few more years of cancer suppression with this new drug.

Good luck.

[jackwfrench in reply to MarkBC]

I am just starting ADT w Lupron, and soon Abiraterone. What did you use before? Thx

[MarkBC in reply to jackwfrench]

I started with chemo and ADT injections (zoladex). This was before data was released showing triplet therapy has even better outcomes. We added bicalutamide after 3.5 years since my PSA starting rising a little. It helped to squeeze another 8 months out of the ADT. One year ago, when my PSA rose to 1.0, we stopped bicalutamide and added abiraterone. This brought my PSA down to undetectable where it remains. My recent scans continue to show just one small lymph node tumour. My bone mets have not been visible for a few years. I am very lucky that my cancer is highly responsive to treatment.

[dhccpa]

What is a positive response on a PSMA scan? No mets at all shown on scan results?

[NDJIM in reply to dhccpa]

My PSMA scan showed uptakes that did not show up on a regular bone scan.

[dhccpa in reply to NDJIM]

Thanks

[Magnus1964]

If aboraterone is the only ADT drug you have been on a rising PSA does not mean you are castrate resistant. You could switch to xtandi.

[spencoid2 in reply to Magnus1964]

a bit confused i am castrated and was on aberaterone and when PSA started climbing rapidly it was decided that i was castrate resistant. Should other drugs have been tried before chemo or now after?

[Magnus1964 in reply to spencoid2]

Did your PSA rise after castration? What is/was the timeline of treatments and PSA readings?

[spencoid2 in reply to Magnus1964]

Yes PSA was rising pretty fast. Was on aberaterone for about a year? after about 7 years with no big change in PSA after radiation and two years of ADT. Not sure of the exact timeline.

[Magnus1964 in reply to spencoid2]

Having an orchiectomy then having one ADT drug fail does notake you castrate resistant. You can still try other ADT drugs.

[spencoid2 in reply to Magnus1964]

so the response to my rising PSA was that i needed chemo. I am not sure if there were other factors considered. It was agreed by two oncologists one a specialist in gerontological urology so I figured it was the right next step. If the chem was not successful would it make sense to try xtandi?

[Magnus1964 in reply to spencoid2]

What is your testosterone level?

[spencoid2 in reply to Magnus1964]

.1 ng/ml was .21 2 years ago

[Magnus1964 in reply to spencoid2]

That's low. You may be castrate resistant.

[spencoid2 in reply to Magnus1964]

testosterone has been steadily dropping but has not been nigher than .3 for a long time so i guess that is why both oncologists agreed that i had become castrate resistant and needed another treatment not just something that reducd testosterone since it was very low already.

[Derf4223]

You need to self-educate on treatments applicable to your specifics, and be able to cite trials. This will greatly improve your MO and RO meetings. Also and its hard, spell drug names exactly correct as they are in some cases very similar but in effect, very dissimilar.

Ask your MO about triplet therapy, which is in the NCCN guidelines.

[NDJIM]

I was on Abiraterone for 2 years and remain on Xtandi. I saw my Radiation Onvoligust yesterday and PSA has dropped from 0.61 to 0.40. This is the first PSMA scan that I’ve had. Previous CT scan showed just a metastasis on L5 and right hip.

[NDJIM]

I had radiation 5 weeks ago.

[NDJIM]

Also been on Lupron every 3 months and Zometa every 6 months for the past 4 years. Had my shot and infusion yesterday and not feeling so good this morning. Trying to stay positive. My Best to all. Jim

[jackwfrench]

My heart goes out to all of you whom have valiantly fought this battle for multiple years- I just started Lupron and soon abiraterone and apprehensive hearing lupron gets more difficult after year 1.