Flare

[MsHope]

Thursday, my husband had his follow-up appointment with Oncologist. I was very alarmed at some of his blood test results. His PSA went up to 1600. Doctor said other blood work was to be expected. I researched surged in PSA and found this, The PSA flare is a well-known phenomenon. The post chemotherapy increase in serum PSA could reach more than twice the baseline value. I can't believe that his PSA went from 600 to the 1600. Has anyone heard of anything like this?

His White Blood Cell count was 8.55 now it is 2.75, red blood cell count was 3.90 now 3.75 and his Hemoglobin was 9.3 now 9.0.

The one good result was his Alkaline Phosphatase was 377 and went down to 203.

His Oncologist said he was okay with the blood test results, it was to be expected.

As I stated, the results were very alarming to me.

I would appreciate any information that could be provided.

Thanks in advance

[GP24]

It seems the chemo is not very effective. I would try to get a Pluvicto treatment instead.

[MsHope in reply to GP24]

You have to have chemo before you qualify for Pluvicto

[GP24 in reply to MsHope]

I do not think that you need six cycles. This is not specified.

[spencoid2 in reply to GP24]

I did 6 cycles but my Onco said that if i really wanted pluvicto he could do just one chemo and say it was not right for me so i could qualify. doing pluvicto now.

[Nusch]

We miss your husband‘s bio, don’t know his journey from diagnose to today. So it’s difficult to advice.

[MsHope in reply to Nusch]

Here are the most recent post I have made.

I haven't posted in a long time. My husband is going to have his first chemo treatment of Taxotere in about a week (1/11) . He has been fighting metastatic stage 4 prostate cancer for five years. Thankfully it has stayed in the bones and not spread to any organs. For those who have had this treatment, can you tell me what to expect after the first treatment? I want to be prepared. Thank you in advance.

Thursday, my husband had his follow-up appointment with an Oncologist. I was very alarmed at some of his blood test results. His PSA went up to 1600. Doctor said other blood work was to be expected. I researched surged in PSA and found this, The PSA flare is a well-known phenomenon. The post chemotherapy increase in serum PSA could reach more than twice the baseline value. I can't believe that his PSA went from 600 to the 1600. Has anyone heard of anything like this?His White Blood Cell count was 8.55 now it is 2.75, red blood cell count was 3.90 now 3.75 and his Hemoglobin was 9.3 now 9.0.The one good result was his Alkaline Phosphatase was 377 and went down to 203.His Oncologist said he was okay with the blood test results, it was to be expected.As I stated, the results were very alarming to me.I would appreciate any information that could be provided.Thanks in advance

[Nusch in reply to MsHope]

Thank you! TA already responded, nothing to add, except: I started with a PSA of 2.222 and chemo plus ADT, RP and RT sales my life. Since two years my PSA is undetectable. Watch out red and white blood cell count, for both there are injections available to support production of new blood cells. That helped me, too.

[Benkaymel in reply to MsHope]

Could you copy this into your bio to save having to keep rewriting it in future posts? Thanks

[Jeremiad53 in reply to MsHope]

Day 2 after chemo, very tired for about a week. I never got used to it. USE THE ICE PACKS, foot and hand.

[Tall_Allen]

Chemo kills cancer cells and dumps their PSA into the blood. It takes a while to clear out.

[MsHope in reply to Tall_Allen]

Thank you so much for your reply. I tried to look up and understand what was going on. Thanks for clearing up. His doctor told him to drink plenty of liquids to flush his system. I guess that gets rid of the cancer cells.

[Tall_Allen in reply to MsHope]

Fluids will help him clear the docetaxel. The PSA from cancer cells will decrease over time.

[spw1]

Keep an eye on The PSA level. My husband was told that it was a surge after the first treatment but after six sessions, it never went down. Scans and symptoms showed progression. My husband was told that chemo was not working after three sessions but the only reason they would not change on the 4th session was lack of proper paperwork in time. First four were docetaxel and last two cabazitaxel. If after the first 3 chemo sessions PSA keeps rising, you should look at scans too.

[Brendan1904]

I would add that all the above replies are very important and hopefully very helpful to you and your husband. I appear to be 2 years behind in terms of diagnosis - extensive in all bones scanned. If I last another 2 years I will be amazed even though I feel quite healthy at present. I have spent 3 years worrying about my PSA fluctuating normally slightly up (now at about 47). My main understanding is it depends what the oncologists feel they can do to the cancer as time progresses, rather than PSA. If they feel they can attack it and keep it in check or shrink it then why not go for it. Thing to worry about is how he feels not any particular test results - let the specialists worry about those.

From outset diagnosis and scans I have been told repeatedly any treatment is purely palliative and while it may shrink and contain the cancer, that has not been their aim. I have kept a close check on my PSA thinking it would indicate when I should expect to start feeling worse instead of the other way round. When I feel bad for several days (possibly weeks) due to what I think is cancer pain I have been expecting PSA to confirm my deterioration. If pain eventually subsides I still expect PSA to be bad. No longer. I now expect PSA to probably rise but while pain goes away and I remain active enough I will continue to hope consultants agree my present treatment is still working (currently Xtandi). Palliative chemo is next on the plan. Over my 3 years PSA has reduced to lowest of just over 30 which I consider worrying and also amazing from a starting point of over 3000. However instead of worrying every time I went for a PSA test I should have been thinking great I am still out walking and getting around the house. I have suffered a couple of setbacks in the last 12 months but after each have been walking again (less than before) and getting around the house, so still going strong. My aim each time I have a setback is to start carefully and try and build up gradually what I can do.

When my oncologist decides treatment is failing and they want to try changing it, my concern will be how the change will affect my mobility and my pain and if I agree it should be to my benefit I will go along with it - without worrying what my blood results are showing. Oh and by the way my Alkaline phosphatase has gone to over 500 latest result, but who cares. I am now worrying (should say interested) more about being able to enjoy the life I have than the treatment I am undergoing and test results.

This probably does not help answer your question. TA is always excellent for good information.

Hope though that it helps you consider looking at the position from a slightly different perspective.

Best wishes and good luck with any treatment choices.

[JD-guy]

Hello, I do not have advice to give, just my experience. Good advice given already. My MO did not check my PSA till after my 3rd infusion because there could be a flair. Hydration is very important, after my first infusion, I became constipated and almost got myself in real trouble, fortunately dried prunes got my bowels moving again. Did they give Neulasta, to keep the white blood count up? They did not give it to me the first time and my WBC went to zero and I got a fever from it. They gave it after that. I wish the best for you and your husband. My PSA went to undetectable after chemo and Xtandi. but I am not the same as I was, but I try to focus on what I have, not what I do not have, although it can be hard at times. God has been so good to me. Thanks

Keith--

aka JD-guy

[NecessarilySo]

I can understand your alarm. The blood cell counts are way lower than normal. As TA says the PSA will come down with time. But he needs to do more than drink liquids. Look at iron level and vitamin B12, and get him to eat foods and supplements to compensate for his lack of nutrition, as necessary.