rising PSA and 'light' advancement of mets in hip bones. Diagnosed stage 4 in March 2021.

[Newdiag-NC]

Greetings!

My husband was diagnosed with stage 4 prostate cancer in March 2021. ADT dropped the PSA quite a bit. We started seeing Dr. George at Duke March of 2023 and he had my husband on a round of docetaxel. After that the many bone mets and some on lungs 'disappeared'. Now it looks like they are starting to grow back. The PSA is not yet doubling since a couple months ago, but it's on the rise. Dr. George has him on Orgovyx.

Anyone out there that knows what this may mean and what options are available? He is immune compromised, so can't do immuno therapy.

We see Dr. George on Wednesday 5/1.

Thank you!

Sherry

[God_Loves_Me]

he is good dr

[Newdiag-NC in reply to God_Loves_Me]

Yes!!! We love him and his team! Is he your oncologist also?

[God_Loves_Me in reply to Newdiag-NC]

I heard good thing from other users

[God_Loves_Me in reply to Newdiag-NC]

he should also take enzalutamide, or apalutamide or darolutamide so talk to Dr for same

[Tall_Allen]

He's only had 1 docetaxel infusion so far? What makes you think they are starting to grow back so soon?

[Newdiag-NC in reply to Tall_Allen]

Hey Tall Allen,

Yes, one full round of Docetaxel.

His PSA went down to .94 Sept. 2023 (Chemo had ended July I think). Then:

Dec. 2023 PSA .96

March 2024 PSA 1.19

April 26, 2024 PSA 1.63. (testosterone 27)

So we saw the rise in PSA and the following text on scans taken a week ago:

'Faint areas of focal increased radio tracer uptake in the right anterior and inferior iliac crest appear new from prior and are concerning for worsening metastatic disease.'

This worries us.

Thanks!

Sherry

[Tall_Allen in reply to Newdiag-NC]

Cabazitaxel would be one option. What about radiopharmaceuticals (Pluvicto, Xofigo)?

[Newdiag-NC in reply to Tall_Allen]

Was just reading about Pluvicto...wondering if Dr. George will bring these treatments up on Wednesday. Yes, he may also suggest Cabazitaxel.

Thanks so much for your help!

[God_Loves_Me in reply to Newdiag-NC]

Do you think Dr George can share next 3 to 4 years treatment plan in advance ? i was reading about similar treatment plan He will start Docetaxel again.

[Newdiag-NC in reply to God_Loves_Me]

We will see after Wednesday!

[God_Loves_Me in reply to Newdiag-NC]

Any update for us ? How was Dr visit ?

[Newdiag-NC in reply to God_Loves_Me]

Hey! Yes, I posted at the end of the replies.

[dhccpa in reply to Newdiag-NC]

One "full round" means six separate infusions? Just wanted to clarify, since some stop early for various reasons. Thanks.

[God_Loves_Me in reply to dhccpa]

Yes just one 1 infusion of ##mg Docetaxel that's all.

[tarzan11]

I also am immune compromised. Sarcoidosis in lungs, lymph nodes and heart. Stage 4 PCa with many bone Mets. PSMA scan last year lit up sarcoid as well as cancer. SUV values in 30s for cancer and 5 or under for sarcoid. On ADT. PSA went from 70 to 0.16. However as time progresses my concern is LU 177 is an unknown in my case. Will it attach to sarcoid cells? If it does good chance it could destroy my lungs which are packed with sarcoid. I am in midst of changing doctors from Roswell to Cleveland clinic. Going to top researcher there for info. Be careful and find out if treatments can make autoimmune disease worse. Best of success to you

[Newdiag-NC in reply to tarzan11]

Tarzan, you sure do have your own fight on your hands! It sounds like you’re quite involved in researching your condition.

Please keep us posted as you start Cleveland Clinic!

With you in the fight, brother!!!💪

Thanks for your reply!

[Boywonder56]

shouldtnt he be on a 2nd drug....one of thate ends in ide...

[Newdiag-NC in reply to Boywonder56]

You are right!

I couldn’t think of which he’s on now, they’ve changed meds so much. He’s on Nubeqa.

[Newdiag-NC]

Dr. George wasn’t too worried about the ‘light’ areas of possible new met development. He is ordering a PSMA PET scan and no other change currently.

I’d love to hear any thoughts you might have!

[God_Loves_Me in reply to Newdiag-NC]

What’s his PSA. ?

[Newdiag-NC in reply to God_Loves_Me]

1.63

[God_Loves_Me]

Agree. I modified the comment. Thank you.