I hope you are doing well. I wanted to post an update about my father's current situation. After PSA started to raise, the MO added Abiraterone 1000 mg. a day with 10 mg prednisolone to his treatment regimen with Zoladex (once every 3 month) and Zoledronic acid (once every month). Abiraterone took his PSA from 70 to 8.97 in one month but after that every PSA test gives us increase in PSA number):
07/06/2024 – PSA 11.9
08/07/2024 – PSA 20.8
04/10/2024 – PSA 32
14/10/2024 – PSA 40
21/11/2024 - PSA 99.3
My father will have radiologic scans to see if there is visible cancer progression, The next steps will be decided after that. His oncologist mentioned possible chemotherapy (he had good response to chemotherapy previously), also changing abiraterone with enzalutamide might be a next step. He doesn't feel any additional symptoms yet but we know that if PSA keeps rising he might get pain in the bones, etc.
What do you think would be the best next step? Which sequence of treatment methods might give us the better results? Any suggestions and ideas would be much appreciated. Thank you.
Written by
gio2x
To view profiles and participate in discussions please or .
We live in an eastern European country and unfortunately, Pluvicto isn't available here. To get Lutetium treatment we would have to go to another country (from what I have read here, India is the cheapest option). Thanks for sharing your thoughts. I will keep Pluvicto in my mind and also discuss it with his oncologist.
Baku might be an even better option for us because it is much closer (we live in Georgia). I will look into it if they are still offering that kind of treatment. Thanks for the suggestion.
Yes, he has no additional symptoms yet other than expected side-effects of hormone therapy. We don't live in the US and unfortunately those clinical trials aren't available here. Thank you for sharing your thoughts though.
After the 08/07/2024 test results treatments should have begun. PSMA Scan to locate the little buggers and what ever treatments the MO would choose.Same now applies.....what has been offered?
We live in Georgia (country, not the state) and yes, I am also not pleased with the slow approach. I was not at the last meeting with the oncologist but my father told me that he discussed possible chemotherapy, enzalutamide or immunotherapy. I will go with my father when he will go there to get radiologic scans and hear more from him. He said that treatment plant will be decided after radiologic scans are done but the PSA is clearly going up very fast which makes me nervous.
I noticed your dear Dad is 66 years old. He (or you) should pounce on his M.O. and get him to help your Dad asap. Give your Dad our regards, and if you wish please tell us where he his being treated (also in what city/state). Thank You!!!
Thank you for your response. I apologize for missing your post above which mentions Georgia the country and not the US state. I always think of Georgia as being part of the USSR since I'm still living back in the mid 20th century (I'm an old guy). Like you, I too am also Asian Caucasian. You have my admiration for being a wonderful offspring of your Dad and watching over him. Keep up the good work..
P.s. I just viewed the capital city of Tbilisi on Google and it seems like a city I would enjoy visiting.
We fought a lot to not be a part of USSR and gain independence. Although our current government seems like they wouldn't mind going back to USSR unfortunately. Yes, Tbilisi has some great sights. Thank you very much for your kind words. I wish you all the best, sir.
When my PSA started rising on Abiraterone, my MO changed out prednisone with dexamethasone and this kept it effective for a while longer. It's a segway to another treatment.
These may be helpful or at least give you a starting point. Some may be in clinical trials here or in other countries.
Thank you. I will mention this trial to the oncologist. What would be your opinion about changing methylprednisolone with dexamethasone as a first step?
We switched from 10mg Prednisolone to 0.5mg Dexamethasone. The oncologist offered us continuing treatment with Cabazitaxel + ADT (Zoladex), no Abiraterone (according to Proselica trial). But the article in the link says that Cabazitaxel + ADT + Abiraterone gives better results in chemonaive patients. What do you think - would my father benefit from the triplet therapy although he already had 6 courses of Docetaxel chemotherapy at the beginning of his treatment (so he is not chemonaive).
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Psa rising 
PSA rising
Rising PSA 
Been on Firmagon with Zytiga and Prednisone PSA rising, what can I do next?
