`psa level

[Brianne07]

I have now been on Firmagon (hormone therapy) for 23 months .I have stage 4+4 with an original PSA of 375.I had 6 rounds of chemo which killed off the majority of the cancer in bones and lungs.Only a couple of tiny spots in the lungs. My professor tells me i have had a very good result on many trips to him.My psa has hovered around 0.008 for around 16months .Is this unusual ? also wondering if i should be on any other drugs. regards Brian

[Tall_Allen]

Great PSA response. Why didn't you have also abiraterone or darolutamide?

[Brianne07 in reply to Tall_Allen]

The professor originally mentioned maybe putting me on Abiraterone but seems to be doing a wait and see.Would you recommend it?

[Tall_Allen in reply to Brianne07]

No, it's too late. Chemo causes cancer cell senescense, so abiraterone will no longer kill those dormant cells.

[Tinkudi in reply to Tall_Allen]

So abireterone should be had before chemo or with it but not after it ?

[Tall_Allen in reply to Tinkudi]

Triplet is simultaneously.

[Seasid in reply to Tall_Allen]

The duration of chemotherapy-induced cancer cell senescence can vary significantly depending on several factors, including the type of cancer, the specific chemotherapy agents used, and the individual characteristics of the tumor cells. In the context of prostate cancer treated with androgen deprivation therapy (ADT) plus early docetaxel chemotherapy, the senescence induced in cancer cells could last from several months to potentially years. However, it's essential to note that chemotherapy-induced senescence is often not permanent, and some cells may eventually escape senescence, leading to cancer recurrence or progression.

### Factors Influencing the Duration of Senescence

1. **Cellular Context:**

- **Type of Cancer Cells:** The genetic and molecular characteristics of the prostate cancer cells influence how long they remain in a senescent state. Some cancer cells may remain senescent for an extended period, while others may resume proliferation more quickly.

2. **Treatment Regimen:**

- **Combination Therapy:** The combination of ADT and docetaxel chemotherapy is intended to be more effective at controlling cancer. While ADT targets androgen-dependent pathways, docetaxel disrupts microtubules, leading to cell cycle arrest and potentially senescence. The effectiveness of these therapies together may prolong the duration of senescence, but the exact duration can be highly variable.

3. **Cellular Senescence Escape:**

- **Senescence Escape Mechanisms:** Cancer cells in a senescent state are not permanently arrested. Over time, some cells might acquire mutations, alter their metabolism, or find ways to bypass senescence signals, leading to senescence escape. This can result in the resumption of cell division and potentially more aggressive tumor behavior.

- **Senescence-Associated Secretory Phenotype (SASP):** Senescent cells often develop SASP, which can alter the tumor microenvironment, sometimes promoting cancer cell escape from senescence and facilitating tumor progression.

4. **Tumor Microenvironment:**

- **Influence of the Microenvironment:** The surrounding cells, immune system, and other factors in the tumor microenvironment can either help maintain the senescent state or contribute to the reactivation of senescent cells. In some cases, immune cells may clear senescent cells, reducing the risk of escape, while in other cases, the inflammatory environment may promote reactivation.

### Clinical Considerations

- **Monitoring and Scans:** Given the potential for senescent cells to escape and resume proliferation, regular monitoring through PSA levels, imaging studies, and possibly molecular tests is crucial for detecting early signs of recurrence.

- **Therapeutic Interventions:** Strategies such as adding secondary therapies (e.g., AR pathway inhibitors, novel hormonal agents) or using drugs that target senescent cells (senolytics) could potentially extend the duration of senescence or prevent escape, though these approaches are still largely experimental.

### Conclusion

The duration of chemotherapy-induced cancer cell senescence can last from months to years, but it's unpredictable and variable depending on multiple factors. Senescence is often not a permanent state, and some cancer cells may eventually escape and contribute to disease progression. Therefore, ongoing monitoring and considering additional therapeutic strategies are important for managing the risk of cancer recurrence after ADT and early docetaxel chemotherapy.

[Brianne07]

If it rises which it will at some stage what sort of drug therapy would i go on ?

[Nfler in reply to Brianne07]

Merry Christmas Brian, as long as psa stays under .20, you have nothing to worry about and on the contrar Abi is thought to cause more advanced pca( Mcpc), so it may have been a good call not to have taken it. You’ve gone thru quite a bit of harsh treatment, let the body heal from the chemicals, you may need the strength down the road. Furthermore, your psa may never rise n you may never have to worry about it. There are options like ivermectin that has shown to reverse castrate resistance in Pca, so go out n enjoy the remaining part of your life as you are doing excellent with a psa of.008. Just an fyi mine is.95 down from 1.95 and I’m on no hard drugs just the ivm and cbd oil and I couldn’t b happier. Again merry Christmas 🎄 n God bless…

[Brianne07]

Hi Nfler thank you for your kind words i will take your advice on board and wish you a safe and healthy Xmas .I am joining a gym this week to force me to do more exercise as the hormone therapy has really weakened nuscles and bone . regards brian

[Nfler in reply to Brianne07]

Happy new years Brianne hope all is well and things are still rolling for you…😁

[CanaryLegs]

My PSA is now 0.08!That’s down from 45.2. Currently taking 2 XTANDI Pills Daily. That Dosage is keeping my PSA at that Number. I’m also continuing to receive a monthly Firmagon Injection.

[Brianne07]

Best wishes going forward sounds like a great result!