Help! Hubby's PSA doubling time one week!

[cancervictim]

Diagnosed 2016, RP G4+5, aRT, ADT + zytiga, holiday, ADT + Erleada. mCRPC Recently completed 6 week Lutetium trial June 2023. Complete response, undetectable PSA!!! Healthy eating, clean living, good exercise. 67 years. No genetic mutations detected.

Doubling time before LU was 2 weeks and I realized that it often decreases after LU. The MO doesn't seem be in urgent mode to do anything and set an appt 2 months hence after he sees the trial Dr.

Why is doubling time so extremely short? Presently PSA is 0.19

On Lupron. Should he add bicalumamide, avodart, cabergoline finasteride etc......?

Thank you so much from a desperate wife!

[Tall_Allen]

Pluvicto can give more room for non-PSMA-avid PCa to expand and grow:

prostatecancer.news/2019/12...

He has lots of good options now, especially Xofigo with docetaxel or Enzalutamide with docetaxel:

prostatecancer.news/2021/02...

prostatecancer.news/2022/10...

[cancervictim in reply to Tall_Allen]

Thanks Tall Allen for your response and optimism. Is it true that he cannot take Xofigo until he has painful bone mets?

Do you think it is better to start docetaxal and enza sooner rather than later?

[Tall_Allen in reply to cancervictim]

The pain can be any pain he has reported to his MO. It is one of those patient qualifications that were used in the clinical trial and were kept, as an artifact, when it was approved,

Sooner is almost always better than later with any therapy - longer survival and fewer side effects.

[Justfor_]

"Undetectable" can be anything if not denoted in numbers. If your husband's "undetectable" was <0.1 in June, 0.19 currently isn't one week PSADT.

[cancervictim in reply to Justfor_]

no, that's the second one. The first PSA 2 weeks ago, and was 1/4 that value

[Justfor_ in reply to cancervictim]

I have a theory of mine that can be visualised as the sudden release of a compressed spring. After a PSA lowering treatment is terminated the PSADT does not revert to the pre-treatment value but gets shortened in an effort to catch up the "lost" treatment time. In my personal case DT was 9.5 months before starting Bicalutamide and when I adjusted the dosage too low it shrunk to 3 months. The good news is that eventually DT gets longer as PSA gets higher. If you retest in two weeks I highly doubt that PSA will have quadrupled.

[cancervictim in reply to Justfor_]

Thank you for sharing this. Sounds like a good theory. I've read that DT declines after Lutetium (link below) but the article didn't comment on if the shortened doubling time eventually increased. My husbands doubling time was 2 weeks before Lutetium. jnm.snmjournals.org/content...

[lokibear0803 in reply to cancervictim]

I’ve always found that doubling time is higher - usually much higher - in the earliest months of my IADT vacations. I’ve decided to stop stressing myself out with “too early” or “too frequent” testing. Much happier now.

But that’s just me, everyone’s situation and sanity protocol is different.

[cancervictim in reply to lokibear0803]

thanks for your post Lokibear. My husband had a pretty consistent doubling time of 2 weeks prior to Lu. If PSA rate slows down to 2 weeks (and incredibly short time all the same) it will perhaps double his lifetime.

[j-o-h-n]

We're different.............. some like cheese pizza, some like pepperoni........

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 09/16/2023 2:27 PM DST

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

John I am somewhat confused of course being on Lupron does not help butI have been eating pizza for years and I have noticed that a pepperoni comes on a cheese pizza.

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

Well you gotta move here to NYC to fully understand.....When you order pizza here It's only with cheese, nuttin else........ All other pizzas are identified (ordered) by their toppings.....Thus a pepperoni pizza is merely a cheese pizza with pepperoni slices on it..... another example would be a peppermint patty pizza is a cheese pizza topped with peppermint patties...and etc.

Like Lupron is on and on and on ...... (catch the drift now?)

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/17/2023 1:48 PM DST

[agnut]

asclepiusopen.com/journal-o...

[cancervictim in reply to agnut]

thank ou Agnut