2 spots

[Howard53545]

I was undetected for a year after pelvic radiation then my PSA went up to .04 so we did a PSMA scan and discovered 2 spots, although one was on a rib. My PSA was .36 so the spots were radiated. I am having a slight pain in the area where the rib is located. My PSA has gone down to .26 so it’s moving in the right direction . My oncologist wants to hold off on ADT until PSA start rising. I know a cure is out now and it’s just a matter of time before it’s all over. Any advice or thoughts.

[NanoMRI]

I am up at 0300 my time, reading up on liver lesions. Mine was recently identified by Pylarify PSMA, uPSA 0.03X, no ADT. Concurrent GUARDANT liquid blood biopsy indicates a mutation. Scheduling additional investigations.

Advice, thoughts? Do not give this beast time and obscurity. Push for all possible investigative methods. Although we face many disparities with this disease one uncontested universal thought is early detection is key.

Been reading that prostate cancer metastasis to liver is greater near term threat than spread to bones and lungs. Awaiting MRI and biopsy to identify this lesion; I am striving to be positive. We both may have more time than our emotions want to give us. All the best!

[Justfor_]

I bash silly docs all the time for their magic numbers and "one size fits all" cookbook approaches. You oncologist is the exact opposite. Strives to understand what is happening inside YOU. Consider yourself a lucky guy to have her/him.

[j-o-h-n]

Hey Professor,

Quote: I know a cure is out now and it’s just a matter of time before it’s all over.

There was never a cure...... and it's always over when it's over. So just keep living the lovely life you have, cause if you keep thinking of the end you'll miss the middle.

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tall_Allen]

Treating your PSA can be different from treating your cancer.

prostatecancer.news/2020/07...

[Janhpr in reply to Tall_Allen]

Dear Tall Allen, looked at the Prostate Cancer news, don’t understand what it means

My husband’s PSA 64, at diagnosis 2008. Abiraterone kept PSA 6 years below 1, but toxic to liver. After Lutetium in 2022 good result zapped some mets and reduced others PSA 1 but rose to 4 within 4 months, referral R223 by the time commenced treatment PSA10.4. ALP down from 106 to 73 PSA 23 told to disregard PSA.

After 4 treatments increase in pain CT showed progression in high coccyx and PSA 33, treatment stopped. Last blood test PSA 59, referral for pain management, patches + oxynorm, oramoph gave nightmare and hallucinations. Stabbing pains across lower back on sitting, bending turning in bed and also rib pain stretching arms, pain still remains with medication. Hospice Dr suggested it might be nerve pain so added yesterday Amitripyline 10mg this morning couldn’t function slept most of this morning felt nausea, hasn’t taken any Oxynorm today only paracetamol feeling much better, this evening still a little unsteady but up & moving and watching his favourite football team, I was very worried this am medication had wiped him out but pain was still there.

Emailed Oncologist about single fraction Radiotherapy.

Would be grateful of your thoughts, many thanks Jan

[Tall_Allen in reply to Janhpr]

What is it you don't understand?

[Janhpr in reply to Tall_Allen]

treating your PSA or treating your cancer

[Tall_Allen in reply to Janhpr]

PSA is a surface protein on all prostate tissue and prostate cancer. It only leaks into the blood serum when something is wrong with the tissue. Tumors develop their own blood supply but the tumor vasculature isn't perfect so PSA leaks out into the blood. Larger tumors have more leaky blood supply, so they secrete more PSA. So you can lower your PSA by eradicating the largest tumors. But the cancer is in tissue reservoirs everywhere, whether they have blood supply or not. So eradicating the largest tumors will lower your PSA without affecting the thousands of cancer sites that haven't yet grown large enough to detect. Whether there is any benefit is anyone's guess.

[Janhpr in reply to Tall_Allen]

So what does that mean to my husband, something I don’t have time to understand what does this mean to my terminal ill husband, just looking to give him more time but free of pain

[Tall_Allen in reply to Janhpr]

It means that hormone therapy, chemotherapy and other systemic therapies should be part of his regimen.

[Janhpr in reply to Tall_Allen]

My husband has done HT, chemo + strontium 89, Abiraterone, Radiotherapy, Lutetium, R223

I read men on this site men who say their PSA is in the hundreds/ thousands and say they are relatively active I question why when my husbands PSA 59 and certainly not active or well

[Tall_Allen in reply to Janhpr]

Everyone's cancer is different in some ways.

[Janhpr]

My husband read your post and following this up. He had Radiotherapy in 2019 got rectal proctitis frequency urgency daily bleeding, anemic and recently had a blood transfusion + IV iron.

Has widespread mets with pain. We think this is in his coccyx after finding progression after having 4 treatments of R223. Single fraction radiation has been suggested but cautioned because of proctitis, any advice

[vintage42]

"... a year after pelvic radiation... discovered 2 spots... one was on a rib... oncologist wants to hold off on ADT until PSA start rising..."

I would think ADT is always important, from the beginning, and especially after mets.