My PSA started to rise from undetectable up to about .36 in July 2021 after 9 years of treatment. My MO reviewed a PSMA and decided to have my largest tumor radiated. My PSA went below .05 once again shortly thereafter. My most recent PSA labs were : .05, .06, .06, and .09 last week. I am conferring with my MO on Friday. My guess is she will have me keep the status who of Lupron and Aberaterone for a while until PSA rises a bit more and then do another PSMA and decide what to do
I would appreciate and scientific/medically based suggestions and thoughts for how to proceed or for questions I should ask my MO.
Please don’t send me suggestions unless they are supported by science.
Thank you.
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jfoesq
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Have you considered BAT? There are trials out there ( based on science). Clinicals Trials are another option, in general. BTW, do the PSMA scans show where the cancer is?
I haven’t considered BAT because I think there are other options still available that have been shown to be effective (generally) at least for a several months and hopefully longer than that, including chemo. As far as my tumors- My largest is in my left acetabulum (hip). I am pretty sure I was DX at the beginning with 2 in my lower vertebrae. I may have 2 in my ribs and can’t recall if one was actually diagnosed in one of my lungs.
When my PSA was low and PSMA scan was clear, I had triplet therapy with Taxotere plus prohylactic radiation of abdominal lymph nodes plus 9 months of Lupron. That gave me 4-5 years of undetectable PSA without ADT.
I’m in the same boat, I’m planning on continuing to get scans and then SBRT for as long as possible, I don’t want to use up other treatments just yet. My MO, Dr. Sartor said I can continue this strategy unless there’s too many areas that appear on a scan or something is found in an area difficult to radiate. I’ll be getting SBRT to a spot on a rib next week. Last year around this time I had a spot on a rib on the opposite side of my body radiated. Last year my PSA fell back to almost undetectable for several months before climbing again, like yours it is still very low. I’ll continue to play whack a mole as long as I can.
If SBRT reaches a point where it is not an option then I plan on using BAT.
QOL, the possibility that if effective I’ll get a boost of testosterone for the time it lasts which would be nice after going without for 10 years. Also the chance for BAT to allow enzalutamide to become effective again. I’d rather hold off on things like Lutetium which comes with significant side effects. Plus Sartor has a lot of experience with BAT, has a good number of patients benefiting from it and he says that given my status I’m a candidate for it.
EdBar has BRCA genetic mutation and his strategy is to save the parp inhibitor Olaparib as a last resort drug after everything else failed.
I believe it is a good strategy as Olaparib will act globally and will wipe out all the cancer from his body whenever it is located.
Therefore he can now sbrt his cancer spots and he could even experiment with BAT knowing that when and if everything else fails he will still extend his life for hopefully two more years with Olaparib.
Parp inhibitor is very toxic but very effective as it could reduce the PSA to very low levels.
I am not a doctor but it is how I interpret it. You could ask him if you want. He made this clear in his previous post.
You don't have to have a BRCA genetic mutation in order to benefit from Olaparib under certain circumstances. Please read this post above for explanation.
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