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PSA the only indicator that Treatment is working

ascott23
Posts: 16
Joined: Oct 2012

Hi,

Just to give a brief background my Father was diagnosed August of 2012 with Stage 4 , Gleason 10 Prostate Cancer with mets to the lymph nodes, hip bone and spinal T11. He was admitted into the hospital due to extreme weight loss of 20 pounds, rectal bleeding, and bone pain.  My Father is 61 years old, was in Vietnam has since been confirmed that Agent Orange caused this. Prior to diagnosis he ran 3 miles a day and is a vegetarian. Doctors diagnosed his Prostate cancer as rare and aggressive and believed prior to final biopsy that is was a sarcoma. They found cancer in all 16 cores of his prostate and labeled it as a Necrotic Carcinoma.

 

It has been awhile since I have posted on this board regarding my Father's condition. As of February of this year my Father's PSA level has gone from 0.004 to 0.22, 0.17, and now is 0.13.

He is also experiencing shortness of breath, when he speaks it sounds as if he is breathy, runny nose, and and a periodic cough?

The doctors at NIH are mainly focused on his PSA level, and he was informed to today that if they see a spike in his PSA again then they will put him on Provenge?

My question is as far as his PSA should the doctors only rely on this as a measure of the disease, and should they request more scans due to his latest symptoms I described earlier?

Once again thank all of you for your comments and suggestions.

 

April

caseyh
Posts: 63
Joined: May 2002

April,

The PSA test is an excellent measuring tool for disease progression.  I know of no other tests that are easily done and as accurate for tracking PCa.  PSA tests have gotten a bad rap because often false numbers are generated during initial PCa diagnosis.  This is not so much a fault of the test as it is poor interpretation of the test results by the physician who ordered the test.  The test is most accurate when several tests are compared to establish a trend in PSA increase or decrease.  I have been doing the test every 3-6 weeks for the past 13 years.  It is extremely extremely accurate.

I am not qualified to comment on your dad's other symtoms, but as long as his PSA is dropping I would not be overly concerned right now.  Should his PSA begin to rise rapidly, talk to your doctors about additionsl scans.

Good luck to you and your dad!

 

 

 

Samsungtech1
Posts: 350
Joined: Jan 2011

PSA is the standard.  Unfortunately it really does not mean alot.  Mine went from 4.6 to 6.4 in six months.  They say agent orange will metastisized as it starts in prostate.  Mine did.  Urologist did not believe in agent orange and did not mention nodule in. Lung.  He was a prostate guy.  My PSA was .33 after removal.  Went Dow and then started back up.  Told urologist about burning in lungs and he said it was probably an aneurism.  I went to hospital and demanded an x-ray.  Expensive without a dr.s script.  Anyhow I now had five nodules.

My point being;you and your father are the only ones who know what is going on.  Do not wait for the dr.s.  tell them what is going on and ask for CT scan, upper and lower, if he is having sore throats get him to a specialist.  They seem pretty slack is this the VA?  

 

Your dad needs to think back to when he was in Nam.  It is the same.  He is fighting for his life.

 

Good luck,

Mike

ascott23
Posts: 16
Joined: Oct 2012

Hi,

 

I want to thank both of you for responding to my post.

I am in complete agreement with you Mike it just seems as if for the last 2 months my Dad has been "breathy", constantly clears his throat, and has a periodic cough.

Yesterday when my Mother was mowing the lawn he was outside with her holding the cord, and started sweating profusely, breathing heavy, and almost past out. He is supposed to go to the Doctor's next week on base.

I know that he is scared and feels that they will admit him again but I keep telling him that we have to find the cause of these extreme side effects/symptoms.

He survived Vietnam and now is having to relieve this war all over again, this is terrible.

 

Thank you,

 

April

VascodaGama's picture
VascodaGama
Posts: 1533
Joined: Nov 2010

April

This is not the first time your dad experiences coughing and shortness of breath. The last time you reported on the condition it was in October 2012. Here is the thread;
http://csn.cancer.org/node/248209#comment-1293551

I think that he should care for any case of anemia in all forms. PCa patients are very much in risk for related illnesses due to the side effects of the treatments. Hormonal manipulations are directly linked to heart and vascular issues. Your dad needs an oncologist that cares about the overall conditions so that I would recommend an oncologist that is specialized in target medication. These doctors look into the whole “picture” (future included) when recommending a drug.

Provenge is an immunological therapy to tackle PCa but it does not cure and it is associated with concerned side effects. You should investigate about the risks and cross check with other existing effects or present symptoms you dad is experiencing.

The rising PSA is low and it may be indicative that the first line hormonal drugs (Casodex) are losing its effect on the cancer. To verify the condition they should get a testosterone test to check for refractory. Image studies would not give any additional information on the causes at this time (low levels of PSA) but the lipids can help in verifying the effectiveness of the drugs.
In any case, if failure is aparent, cancer may still be controlled with second-line HT drugs like Ketoconazole or still better the newer antiandrogen Xtandi (enzalutamide- MDV3001) or Zytiga which may not add any symptom to the ones your dad is already experiencing.

He can always get into the immunological therapies after the above period.

Discuss with his doctor about the above and try getting second opinions before committing.

Wishing luck and peace of mind to your family.

VGama  Wink

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