The Gleason 9 and 10 Crew - Welcome and how ya doin'? (Part 4, continued thread)

reply to Sr Sailor regarding variable responses to 177Lu-PSMA-
some correlations exist-
Some extreme responders also carry BRCA mutations, which cause defect in repair of double strand breaks, which the radiation causes to happen in cancer cells

over many administrations of the drug in Europe and Australia, patients with only lymph node metastases seem to fair better; median PSA decline of 92% vs 72% in patients with nodal mets plus only 1 or 2 bone mets; longer time to progression, better survival.

there was a trial of this drug that predated VISION here in the states; used a "cost-recovery" mechanism where subjects could be in a trial if they paid $10K per injection for the drug; shut down now due to lack of relevance because of VISION, but one subject showed mixed response after two injections: very substantial increase in bone and organ met volumes with 97% decrease in lymph met volumes

reference for lymph node study
https://doi.org/10.18632/oncotarget.26789

rf

Fairwind,
Hope you get a good response.

Good luck!

Hi Grandpa Marv - I am sure the last 4 months have been tough, starts out with a concern and the next thing you know, you are up to your knees in learning about PCa and what all the abbreviations and numbers mean..

My guess is the doctors are not going to be pushing surgery given your age and the fact that your high risk cancer is probably outside the prostate but you never know. The MRI should provide some insight of what is next. Might consider a PET scan at some point to get more info on where the PCa is or isn’t. The second opinion at JH is a real good idea and should provide some additional guidance. Probably some good resources in DC as well.

It might be a good idea to start your own thread (New Topic) so everyone sees it and can help as needed.

Yeah, the G9/10 thread has been going on for a long time and veers in many directions so many do not even look at it often. I only do it once in a while and happened to see your post.

The low PSA situation happens from what I have read. No one knows why, the PCa just does not generate the PSA in some people.

I would agree that EBRT of some variety + high dose brachytherapy + ADT (the triple play) will be suggested but additional scans will help with that decision.

Fairwind-
I am very glad you are in the treatment arm. We are three weeks apart for injection dates; I get #4 next week. keep us posted and great luck to you-


grandpamarv- everything in your posts suggests you are getting good treatment; best luck to you, friend, it sounds like cure is possible for you; be well-

rf

Diagnosed with Stage 4 prostrate cancer March 2019. Extensive bone metastasis and multiple lymph nodes involved. Gleason score of 9 (5+4). Age 73. Getting ADT shot every 3 months and taking generic Zytiga and prednisone. On diagnosis PSA was 14. Went for my first 3 month checkup to Urologist and got another shot. My PSA is now 21 from 14. Had to go for another CT and bone scan. Have not gotten results back yet. Concerning that my PSA did not go down after generic Zytiga for 3 months. Anyone with similar experience?

Hi,

I was doing fine up to this morning when I saw my PSA and testosterone lab results. I guess you can see my situation and my treatments in my signature but here it is again. I'm 47 years old, two years ago DX with G9, mostly %100 with perineural invasion, MRI, PET Scan, CT Scan, GA68PSMA PET Negative Mar-May 2017, Completed IGRT 46Gy, Brachytheraphy 110Gy, Chemotherapy, HT Lupron for 2 years. My PSA was <.1 during the whole treatment. My oncologist was saying <.1 is undetectable but after reading comments here that actually should be <.01. So I'm kind of confused there. That might be Kaiser standard. My testosterone was low teen during HT until today's result. I am at PSA 0.2 and T 625. Those are huge percentage increase in 3 months. I'm not worried much about testosterone level. But PSA has increased between %100 to infinity mathematically speaking. My PSA could have been 0 or near zero 3 months ago. Testosterone level increase is unusual too, 60 times more than previous test. No wonder I have been feeling great after completing HT, going to gym 5 times a week and getting back into shape and a huge increase sexual activities.
I'm just very concerned about the PSA increase rate. Are this rates normal? if there's a normal for a cancer patient.

My PSA went up from <.1 to .2 in three months but it's at 6 months past ADT.

Wow. Almost 3 months and no activity in here at all. Maybe that’s a good thing. Figured I’d bump it up a little in the page count.
Just had my PSA and T levels checked. My last actual injection of Lupron was July 2018.
My T level today is far from impressive. Will need to speak with my MO this week. It is however slightly up from 156, 6 months ago to 160. Not what I wanted to see.
My PSA is still at <.05. That I can live with

Tomorrow will be my 2 year anniversary of starting Zytiga. Still <0.01. Wishing all a good holiday season and a healthier New Year.

Unfortunately yes. But it is not a reason why there is no activity here. The loss of Rockyfords has taken its emotional toll on the group. There are still people looking for advice and support. I’m sure Rockyfords would agree.

Made a few errors in my signature, hope it is now corrected. uPSA prior to SRT was 0.11