PSA going in wrong direction

[Jvaughan0]

Finished 37 radiation treatments to aortic lymph nodes a week ago after a PSMA scan highlighted three avid nodes in August. Started orgovyx three weeks ago and nubeqa four days ago. Visit with my MO revealed a PSA increase from .21 in August to .7 today. Seems the numbers are defying the treatment. Thoughts anyone?

[Tall_Allen]

Dead cancer cells release PSA into the serum.

[Jvaughan0 in reply to Tall_Allen]

I'm hoping that's the case. The avid nodes were small to begin with and my RO said they became smaller during treatment. It just seems a big jump within a small window of time.

[Tall_Allen in reply to Jvaughan0]

It would be troub ling if there were no increase in PSA. Your RO should have told you to expect that.

[ron_bucher in reply to Tall_Allen]

I haven't had any treatments since 2017. After several years of undetectable PSA, my PSA has been very slightly rising monthly with an occasional significant PSA decrease. Could my PSA up and down trend be explained by my body killing cancer cells?

[Tall_Allen in reply to ron_bucher]

No.

[billd50]

As Tall_Allen says, PSA goes up as the cancer cells are killed. It caused me

concern as well, after getting SBRT on a lesion to my vertibra. The doc

didn't tell me either. It took about 3 months after finishing SBRT before

PSA went down. Yes docs don't always tell you what you need to know.

Of course check with your doc.

[Mgtd in reply to billd50]

I have always wondered why MDs do not use a checklist for routine briefing items like routine effects that they never seem to mention. Is it something in their training? After twenty years of flying military aircraft I would never ever had considered not using a checklist except in critical emergencies where you had memorized BOLDFACE and then time permitting I would run through the checklist for clean up items.

[billd50 in reply to Mgtd]

Hi Mgtd,

I'm an AF guy myself. I love checklists. A great book about checklists "Checklist Manifesto" written by Atul Gawande talks about the use of checklists in aviation. I've developed several checklists for my Prostate Cancer support group. The checklist tells a guy all the things you need to do before, during and after ADT. I've never seen this info from a doc. They treat every case as if it were the first time it every happened.

[Scout4answers in reply to billd50]

Would you please share your ADT checklist. Perhaps as a new post.

TIA

[billd50 in reply to Scout4answers]

I'll post my ADT Checklist as a separate post. Thanks for asking.

[billd50 in reply to Scout4answers]

It's posted.

[Scout4answers in reply to billd50]

Thanks

[wilcoxsaw]

I've had focal proton treatment on several nodes as well as 1 rib on 3 occasions, the latest a hilar node 3 weeks ago. My psa today was under 0.014. I've never experienced a rise in psa right after treatment. Was also on ADT beginning a month prior to each treatment. Not sure why your doc did not want you on ADT prior to beginning treatment to radio sensitize the cancer.

[Jvaughan0 in reply to wilcoxsaw]

I've been on ADT for two years. Lupron alone was starting to fail.

[wilcoxsaw]

I have been fortunate that that hasn't happened to me yet. Best of luck on your treatments!

[j-o-h-n]

Nubeqa four days ago? The 16 tablets haven't even had time to dissolve in your stomach yet....I've been on "eqa" (I'm finally getting the hang of abbreviating my posts, like a big shot) since April and will see my M.O. (at MSK) in two weeks to get a number on my PSA. If you're interested how it worked on me...... just message me and I'll respond asap (no fee involved).

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 10/27/2023 10:58 PM DST