Growing mets with low PSA

Last year, when I was diagnosed with extensive bone mets, my PSA was 48.4. Lupron and Casodex brought it down to 1.16 which is where it stayed until September when it started a monthly doubling. In December, my second bone scan showed some change in the existing mets but 3 new ones.

In late December, early January, I had the Provenge treatment which brought my PSA down to 5.04. This last month, it started to climb again with a PSA of 3.75. This is a relatively small change but here is my concern. My cancer looks to be growing despite having a low PSA.

I have another PSA test next week and another bone scan next month. If my PSA continues to rise and the bone scan shows new mets, would you pursue the next treatment option or wait?

Hello JC,

Sorry to hear about the rise in PSA after Provenge. But at least the doubling time is significantly slower than what it was before the Provenge. If the next round of testing showed rising PSA and new mets, I would want to look at other options.

From your history in your signature, it looks like you haven't had a bone scan in 14 months so it's pure speculation as to whether your cancer is growing faster or slower than what the PSA would indicate at this point. I think it's necessary to wait until the next bone scan for more information before attempting to draw any conclusions.

I'm somewhat surprised that Xtandi and Zytiga have not been part of the treatment plan to date, but those would be good options to explore this point.

I hope you are under the care of a really good medical oncologist specializing in prostate cancer at this point. And that you have pursued at least one 2nd opinion from an expert at an independent medical institution (separate from the institution that is home to your primary physician) to make sure that you are covering all the bases and have the best possible plan in place.

JC,

Mate, you have had quite a journey! All the best!

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Thank all of you for responding. Just a quick update. I did have a bone scan in December. The oncologist said my existing mets had shrunk somewhat, but I had 3 new ones. When I asked him if he considered it good or bad, he responded bad. No pains yet, thank God, just fears.

By the way, this may be a no-no, but if you want to add more to your signature than the amount of words allowed, create it in notepad, and paste. Once pasted, do not touch it or it will screw up.