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Is the PSA really just a number...?

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Posted 8/22/2013 5:53 PM (GMT 0)
Hi everyone,

Dad's PSA has been rising steadily for the last few months (his treatment is Lupron and Zytiga). However, after the first rise in PSA the CT scan actually showed the one lymph node invovled decreased in size and the bone scan was stable. For 3 months it kept rising so the doc repeated the scans. Bone scan is still stable but CT scan shows the one affected lymph node grew by 7 mm (she said if he were in a clinical study they wouldn't change the course of treatment over one small change like that) sooooooo... we stay the course --- Zytiga until December when we repeat the scans and look for changes... she expects a steady rise in PSA between now and then but said we will "milk" the treatment as long as we can.

My question is... doesn't the 7mm lymphnode and rising PSA prove Zytiga really isn't doing its full job? We know prostate cancer progresses slowly so I'm imaging in December we'll see maybe a second lymphnode or a new bone lesion??

 

Is PSA really just a number...I mean if it's rising...doesn't that have to mean something is going on...even if we can't see it yet? Why not proactively change treatment to stay ahead of the game rather than working after it?

Posted 8/22/2013 6:15 PM (GMT 0)
You are out of my league with respect to PSA and Zytiga as I am not yet hormone resistant.

One thing I can comment on though is bone mets. You may want to augment the bone scans with MRI's. In my case the part of the bone scan that really looked like a laser light show was in fact benign, and the result of a previously unknown and inactive herniated disc at T7&T8 (no pain).

However, I still have confirmed bone mets on T4 and T9 and so called mild bone metastasis and well as not so mild mets on sacroiliac that on bone scan appears more minor, just a non symmetric dot on right sacroiliac versus on left.

For different reasons, other than the Doubling rate, PSA has not been a very good indicator for me (I was only PSA = 3.68 at diagnosis and since then Lupron has steadily decreased it). So we rely more on bone scans, and in past month MRIs and CTC Circulating Tumor Test were added, which the latter showed good news.

https://www.healingwell.com/community/default.aspx?f=35&m=2829595

Where you are at now, I will be someday. So appreciate all the knowledge and experience you share for the rest of us.

Best of luck to you.

LupronJim
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