another increase to my husbands psa

[Murphpup]

my husband was diagnosed with Oligometastatic prostate cancer and completed 39 radiation sessions along with 2.5 years of adt therapy and Zytiga.

Last adt shot was April of 2024

We have noticed a rise now with his psa and have been doing three months to monitor

Jan 2025 .1

March .12

April.18

we are not on any medications and of course I am concerned! .when it hits 2 then we will do a petscan according to his Dr.

we did 39 sessions of radiation followed with 2.5 years of adt and Zytiga

He still has his prostate so it does produce serum. Also now his testosterone has came bank.

Next Dr appt is in May! Any help suggestions on where to go would be most helpful to ask his Dr! Thank you all

[Tall_Allen]

if he has distant metastases, he should never have a break from ADT+Zytiga, unless he requested a break.

[Murphpup in reply to Tall_Allen]

He does not have distant! His dr recommended that we come off medication! Now look! I am scared !

[Tall_Allen in reply to Murphpup]

What do you mean by "oligometastatic"? If he is just N1 (pelvic lymph nodes), he is not oligometastatic.

[Derf4223]

@Murphpup Please put case details in your bio. I hear its bad karma not to.

[NanoMRI]

Because you asked I would be asking (well I push until I get) for imaging, perhaps start with an mpMRI (yes even after RT). Also, I find liquid blood biopsy testing very useful (despite naysayers which includes doctors). IMHO less important as to what we call various stages and more important to get earliest detection. This is an interesting read with interesting definition: pmc.ncbi.nlm.nih.gov/articl...

I hope this is at least somewhat helpful. All the best!

[groth12345]

I had similar treatments starting at diagnosis (Gleason 8/9), age 69. 2.5 years of ADT (Zytiga/Lupron). Then 25 doses of radiation to the prostate and 25 doses to the pelvic region a year later since a lymph node was enlarged. PSMA Pet scan showed low volume distant mets (4) but not 100% determined as prostate cancer (could be from injuries, etc).

I've been off Zytiga for 16 months and Lupron for 13 months. PSA went from <0.02ng/mL to 0.17ng/mL as recently follows:

Apr 3, 2025 0.17ng/mL

Feb 19, 2025 0.184ng/mL

Jan 6, 2025 0.1ng/mL

Dec 2, 2024 0.08ng/mL

Nov 4, 2024 0.1ng/mL

Oct 1, 2024 0.05ng/mL

Aug 28, 2024 <0.02ng/mL

Testosterone went from 0 to currently 400. Dr also suggested that since I still have a prostate, anything below PSA of 2 is considered normal. Rate of rise is also a potential concern. Sounds like your husband is on the right path and could be in full remission. Keep checking PSA every other month as I do. Good luck!

[Noname1960]

I had Gleason 9 in 2017 and had my prostate removed. I went a little over a year and my PSA started to rise again and had 40 radiation treatments and a Lupron shot. I was good until the first of this year and my PSA is on the rise again they did a PET scan and the cancer is back for the third time. It is small and my PSA is low only .187 but it shouldn't be any at all since my prostate is gone. MY doctor said since the cancer is small and my PSA is so low he is fine with monitoring it and running another PET scan in June because the sooner we start treatments the sooner we run out of options. They can't do radiation again because it is in the same place as last time and it can cause internal damage if they radiate they same area twice. I am not sure what part of the country you live in but I see Dr. Burgess who is head of Levine Cancer in Charlotte NC. He was highly recommended by the doctor that did my surgery in Tacoma Washington. I flew out there because my daughter is and RN and her husband is a certified first assist in the OR and they said Dr. Willis was they best they had ever worked with. He did my surgery and took 22 lymph nodes and it was only a month after it was discovered and was already in 19 of the 22 he removed. He did it robotically and I had very little pain and was able to go home the next day because of my daughter and her husband could care for me.

[groth12345 in reply to Noname1960]

I'm assuming you are still on Lupron. You should also pair that up with Zytiga for the adrenals. If castrate resistant, you might want to try Lu-177. There are numerous other treatments. A lot will depend upon what the PSMA Pet shows but it isn't 100% accurate from my experience.

[j-o-h-n]

to Murph and pup

Would you please update your bio.......... it helps him/you and helps us too. Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n