My psa stays same with hormone therapy

[Deecer]

I started hormone therapy abitaterome and eligard in April for metastatic prostate cancer. I feel great. When I started my psa was 125. In June it was 7. But my last test in September it was still psa 7. Didn’t go down. Doctor not happy. Would like to see it at 0. Any thoughts ?

[pjd55d]

it took awhile - 9 months to a year to get to undetectable

interesting that the DR is not happy - do they have any suggestions ?

[fireandice123]

Getting down to zero is certainly the preferred goal but that’s not always how it works out. And as stated above it can take a while and it’s often not a straight line down. Going from 125 down to 7 is good and the fact you seem to be stable is also good. It’s certainly better than it going back up.

Maybe a PSMA scan would be in order to get some degree of clarity as to what is going on.

[Atdabeach]

Do you have any idea what your testosterone level is? The point of Eligard is to drive down your testosterone, which in turn feeds the cancer, which gives off PSA. But even men without cancer have a PSA score, hopefully less than 10. If your testosterone is near zero, the ADT is doing its job, but it's also possible to be castrate resistant, where the cancer thrives even without testosterone. Sounds like you need further testing to see what's going on. Is your doctor a medical oncologist? If not, you should see one.

[Cenerus in reply to Atdabeach]

This is a good question. You should get your testosterone tested to make sure it's been properly suppressed. If it is at castrate levels, then you probably have some disease that is castrate resistant. I'd have a serious talk with the MO about getting Docetaxel or spot SBRT for any Mets that are lighting up as active on a pet scan. Probably both would be a good idea.

[Tall_Allen]

125 to 7 is pretty darn impressive. You probably have a few resistant metastases. You can have a PSMA PET and zap them to get your PSA lower, but I don't know if it matters. Is there a reason you also didn't have docetaxel?

[cesanon]

That's not bad. It's the trajectory that counts not the absolute number.

It looks like you have a zero doubling rate.

Much better than being at 0.5 and watching it double every 2 months.

[pakb]

My husband's PSA has never gotten to 0- he's 7 years into his gleason 9, metastasis to several bones, diagnosis.

[Jbooml]

ya..some of us crash down to undetectable in months, others grind down. I attribute this to individual treatment perfusion and cancer colonization traits. I’m convinced some cancers have low homogeneous metastatic colonization traits susceptible to meds especially sclerotic bone involvement which predisposes it to good treatment outcomes. It’s a lottery unfortunately for some. I was told I was likely infected for a decade before treatment. When ADT was administered My PSA dropped nearly 1000 pts.

With seemingly little help from Zytiga you might consider finishing off the last holdovers with taxol. Not a happy prospect but we all play for keeps as survivors in our war with our malicious hitchhikers where idle tolerance can result in dire consequences.

I’m not a doctor but very wary of our enemy and have used all of my wits and uncovered tools to preempt its dirty tricks…I take no prisoners

[j-o-h-n in reply to Jbooml]

Note: Jbooml is considering changing his UserID to "Kick Ass"....

Good Luck, Good Health and Good Humor.

j-o-h-n

[dk73]

sounds like it’s working. My husbands went down quickly but it wasn’t too high to start. Worked for about a year before the PSA started doubling each month

[j-o-h-n]

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Good Luck, Good Health and Good Humor.

j-o-h-n