Does PSA of 209 mean cancer?

Hang in there, Onthgodiy. You have an advanced case, but lots of treatment options. As Saipan suggests you need to get to a first class major medical center, and see an expert medical oncologist who specializes in prostate cancer.

South to Emory in Atlanta, east to Duke, southwest to MD Anderson in Houston. Do it quickly. Hoping for the best for you.

Some very fine choices at Duke:

https://www.dukehealth.org/search-results/doctors?fq=treatment_term_name:"Prostate%20cancer"

Post Edited (garyi) : 2/8/2018 11:23:27 PM (GMT-7)

hi guy-
I am sorry you are facing the beast- I offer comments based a lot on my experience of two years (so far) after diagnosis of de novo metastatic PCa-

(1) you will go on ADT of course ASAP- this usually has a big impact on tumor burden initially- your PSA should drop dramatically and many of the tumor sites will shrink substantially-

(2) I am not sure what your doc means by "aggressive" chemo, but if it is docetaxel alone, many guys get through it without truly debilitating side effects- some continue working while on regimen; I am glad I did not have to, but I only had 4 rounds (not 6) because of skin reaction-

(3) between the ADT and the chemo, if you respond to both, you could get your PSA really low, which is then the floor for the return of the beast; some guys will have an extended period of low PSA before castration-resistance, you could be one; my PSA started climbing shortly after my last chemo treatment, but my nadir was 0.05 PSA about 6 mos into treatment (chemo + ADT), and after two years my last PSA is 3.03 and I am still relatively symptom free from the disease itself; it is a good year so far.

(4) for me the first year was the hardest emotionally- the combo of coping with the diagnosis and the onset of ADT side effects was draining- things seemed to change going into 2nd year- I am still fighting (on my seventh form of PCa therapy now) and as long as major symptoms are held at bay, I feel pretty normal most of the time- all that bad stuff that will happen, well it will happen to a guy I do not know now (me of course) and off in the future.

(5) any time you buy now may gain you access to treatments, proven or on trial, that can give you more time later- things are developing real fast in PCa these days

(6) chemo can be very rough on some people- part of that depends on your current health status I guess- but you will never get better benefit from it than now- later, after castrate resistance, chemo is also used, but to less benefit with regard to time-

I make no recommendation, of course. But there is a thread on this forum called "Taxotere side effects" where many have detailed their experiences with the drug- and Cyclone Fan has placed an excellent write up on preparation for and managing the chemotherapy. It may help you in making your decisions.

I wish you great luck -
rf

My Urologist wants to introduce me next week to his oncologist of choice. What I meant by "aggressive chemo", is a combination of multiple chemo drugs together with hormone therapy over about a 6 month period. I have heard of so many success stories with radiation & hormones, I'm not inclined to agree with chemo. I am still looking for 2nd opinions. My urologist wants to start the hormone treatments immediately. Should I do this before I get a 2nd opinion?

Thanks, Almost a 10 for your thoughts. I'm glad chemo worked for you. I recently watched my father-in-law die from a regimen of chemo fighting two cancers at once, prostate and adult onset leukemia. It was awful. The poor man was sicker than he was alive for the last 6 or 8 months of his life. Similarly, my favorite uncle died within 9 months of a cancer diagnosis, he took chemo and was unconscious for over half the life he had left. I have heard examples of much better results with a combination of radiation and hormone therapy. I don't think chemo is for me. Again, I'm glad it worked for you.

Good evening Onthgodiy,

Welcome to where no body wants to be!! I'm so very sorry to hear of your diagnosis! You're at the right place for great advice and a family atmosphere.

Here is my story.... I was DX 10-3-2012, stage 4, very aggressive, high volume, PSA 130, metastasis from right and left skull down to my femur! Given 4-5 years to live at best!! I'm doing very well and still on my first line of defense and PSA is <0.064!! Giving thanks to my faith, my doctors and the medicines! Take care, Dave in Bartlett, TN.

Born: 10-28-1950; October 1, 2012, I was diagnosis with Advance Prostate Cancer (Adenocarcinoma) high volume, very VERY aggressive metastatic and prostate was 4X the normal size, stage 4! My PSA was 130 and Gleason score 9. Numerous skull lesions most prominently on my right occipital lobe (skull); cervical spine particularly and thoracic spine, multiple ribs; fourth vertebral and my T12 vertebral was eaten up with cancer and I had to have 10 rounds of radiation and had kyphoplasty surgery (11-6-2013) to rebuild my T12 vertebral. My urologist told me that I had four to five years at best! 10-1-12, I started hormone therapy: I started Bicalutamide (Casodex) 50 mg daily and on 10-3-12, had my first monthly injection of Firmagon and Xgeva. Per my urologist, first told me the first line of defense of hormone therapy would only last 12-18 months before having to go to something stronger! MY WIFE, FAMILY AND I, WERE DEVASTATED to say the least!! As of TODAY, I’m still on my first line of defense and my PSA is <0.064!! Last few bone scans have shown that the tumors are fewer!

Having several bulged disc, having lots of pain in my lower back, right hip/butt! Have had several nerve blocks over the past several years to no avail!

During my journey with PCa, I've put my faith in God, a positive attitude, my doctors and medicine.

I'll keep you and your family in my thoughts and prayers!

Dave, in Bartlett, TN