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PSA constantly rising

moonlitnight
Posts: 58
Joined: May 2013

Forgive me, I just want to rant. My husband's PSA has been steadily rising from a nadir of .24 and he is apparently castrate resistant after just a few months. It is now 7.0. Last month it was 3.9. The cancer centre doc says he can have a CT scan and a repeat bone scan (finally) but neither he nor our regular oncologist is particularly concerned about the PSA. It will be treated in a month or so, after seeing the results of the scans, with either enzalutamide or abiraterone. His bone density is excellent and he is asymptomatic, but this is wearing us down. Dr. Lam (we had a telephone consult with him) would like to see the PSA under .05. Sholtz says the same and says this should be tackled immediately. It's so darned frustrating. Our onc. actually said, "Let's see if it will drop again in the month that we are waiting."

VascodaGama's picture
VascodaGama
Posts: 1589
Joined: Nov 2010

MLN

I am sorry for the news. The increase is fast with short doubling. I think it better you get to Lam the soonest. Your oncologist comment "Let's see if it will drop again in the month that we are waiting" does not improve anything apart from confirming AAWR (antiandrogen withdrawing response). Your husband needs to return to HT and this time he should get advice from a medical oncologist of the grade of Lam.

Dr. Myers would probably add a daily Leukine injection to boost the immune system while in the protocol of Zytiga (abiraterone) or Xtandi (enzalutamide), at this phase of treatment.
There is a forum member from Canada who followed similar steps with success. In this link you can follow their story. You can also try contacting Mia99 for any discussion on the matter;

http://www.healthboards.com/boards/cancer-prostate/934811-cant-get-psa-zero-2.html

This is also the best timing before any HT to look for oligometastatic cancer with an image study. The PSA at 7 is high enough to consider that something would be detected in modern machines 3-tesla. Dr. Myers would probably recommend you to get the C11 PET/CT scan instead of the traditional CT and Bone scintigraphy scans. Our comrade Traveler, a member in this forum, successfully got rid-off a small metastasis in bone that may have been the cause of his recurrence. He managed to locate it and spot radiate doing a C11 PET/CT scan.
http://csn.cancer.org/node/261390#comment-1423355

I hope your husband returns to the control seat.

Your previous thread: http://csn.cancer.org/node/264806

Best wishes

VGama

moonlitnight
Posts: 58
Joined: May 2013

He is still on nilutamide and degarelix. Thanks for the links. We are going to call Lam. Have an appt with Myers OCtober 3 (the earliest we could get in).

bertito
Posts: 14
Joined: Apr 2002

Very sorry about your husband's elevated PSA. I would seriously consider the transfer to a Cancer Center such Anderson Cancer Center where they are equipped to handle advanced cancer patients. They have a multi disciplinary approach in place and advanced technology.

I would also demand the elevated PSA be dealt with NOW!!!!

 

Best luck to both,

Bert.

VascodaGama's picture
VascodaGama
Posts: 1589
Joined: Nov 2010

Trying to figure out the occurrence. You said in your December 2013 post that bicalutamide has been pulled off. Is his doctor trying a different antiandrogen?

In any case, the rise of the PSA indicates that the present protocol is not enough. You need to get advice for a newer protocol and you should reveal to Lam the whole list of supplements, etc, your husband is taking because those can interfere or interact with the medications.

Wishing you luck and good response to the next protocol.

VG

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