PSA rising

[Lindajda]

Two months ago, husband’s PSA was .23, last month .20, yesterday .27. MO wants to watch and see what it is next month. Husband diagnosed 9/23, finished 6 rounds chemo on 2/21, is on Zytiga and Orgovyx currently. Concerned about the rise in PSA, would like input. Thank you.

[Tinkudi]

I think the dates seem wrong ?

[Lindajda in reply to Tinkudi]

Chemo finished 2/21/24.

[GP24]

"diagnosed 9/23, finished 6 rounds chemo on 2/21, is on Zytiga and Orgovyx currently" Your husband has very advanced PCa. You cannot keep the PSA value undetectable with Zytiga and Orgovyx for many years. I would switch to Xtandi when the PSA value gets over 2.0 ng/ml and try to get a Pluvicto therapy then. Do not worry about the PSA fluctuations, you do not need a change in therapy.

[Lindajda in reply to GP24]

Thank you for your input. Yes, stage 4 Mets to pelvic bones and left femur. I’d like more of your opinion as to why Xtandi. Not challenging you, just need to learn. Thanks!

[GP24 in reply to Lindajda]

A switch from Zytiga to Xtandi/Enzalutamide is the usual switch in that situation. Xtandi will bring down the PSA value again for several months. On the other hand it will increase the PSMA value and make Pluvicto more effective: thelancet.com/journals/lano... If you do not plan a Pluvicto therapy you can choose Erleada/Apalutamide as well.

[Lindajda in reply to GP24]

Thank you

[Tall_Allen]

There is nothing further that can be done until PSA is higher or rapidly increasing.

[Lindajda in reply to Tall_Allen]

Thank you