My dad was diagnosed with stage 4 metastatic prostate cancer over a year ago (history of his diagnosis is in my profile). When he was diagnosed he did triple therapy (docataxel, zoladex and nubeqa). He has now on zoladex injections (every 3 months) and nubeqa (darolutamide) tablets daily. Thankfully these medications have been working great for him, his PSA has stayed down and he's had very minimal side effects. Praying this is long lasting.
While it has been an immense relief to see the medication working, I am worried that we are "treating PSA" and not the cancer. While he is doing great (knock on wood), i don't want to get complacent in his care. Currently, his MO has him doing blood tests every 3 months and looks at a handful of figures (PSA, testosterone, etc.). I am wondering if there are any other tests or anything else we should be doing, my worry is us just focusing on PSA to tell whether he's doing good or not, i want to make sure we don't miss anything. Does anyone have any advice on what else I can be doing or questions i should be asking his MO to ensure nothing get's overlooked on our end? Are there any signs any other tests, etc.?
Appreciate you all, this community has been my lifeline this past year.
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Jdhanoa
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Yes that is true, i guess i meant to state when we do his 3 month check in's his MO is looking at just a handful of numbers (psa, testosterone, etc.). Is there anything else we should be doing to monitor? Currently just blood tests every 3 months and basing how he is doing based off the blood test figures
My ltd understanding is that progression of cancer is more recently measured through what shows in scans, as in radiographic free progression. I am also seeing use of measures of CTC circulating tumor cells, and NLR.
Don't forget the benefits of exercise. As much as your Dad can handle. A good balance between aerobic and strength training. And it's important to remember that exercise is not just good for you like some paternalistic pat on the head, but there's serious research that especially resistance exercise helps directly fight prostate cancer. See "myokines". A continued success for your Dad!
Definitely agree, we were told by many amazing individuals about the benefits of exercise on this platform and because of that, exercise has become a massive part of his journey and we attribute him doing well a lot to this. So many of his previous aches and pains went away once he started daily exercising. Thank you!
Other treatment surveillance tools include periodic (annual?) imaging (consider PSMA PET, mpMRI or NaF PET, given his bone mets). I also monitor my bone-specific alkaline phosphatase (for bone turnover) and CTx (for bone resorption). Those are blood tests. See this article for more discussion, but I would work with his docs to pick just 1-2 additional blood markers plus one imaging method.
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