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Posted 12/8/2016 8:08 PM (GMT 0)
Dad went for his Lupron injection today and the dr told him that based on his improving prostate symptoms (less incontinence, less frequency, etc) that it sound like the prostate is shrinking which indicates the ADT is working.

Also his said it was good that his PSA had risen from 2.3 initially to 6 after one chemo treatment bc that also meant that the treatments were working. He said it would be different if his PSA was high initially but bc dads was only 2.3 upon diagnosis, he would expect it to go up at first.

Does all this sound right? I want to believe this is good news but his case has been so odd thus far, I'm hesitant to get too excited.

Thanks for any opinions!
Posted 12/8/2016 11:52 PM (GMT 0)
It sounds kosher. It'd be easier to respond if you added a signature with some details of his diagnosis and therapeutic history.

From what I gather, he was diagnosed with the kind of PC that puts out little PSA. I'm guessing he was diagnosed with metastases as well. The docetaxel killed a lot of PC cells and the dead cells dump their PSA into the serum, which is why PSA often increases immediately after treatment, before it goes down.
Posted 12/9/2016 1:43 PM (GMT 0)
Thank you Allen. I tried to modify my signature to include details but I'm quite techno illiterate😂

So in case it doesn't show, yes he was diagnosed with aggressive PC, Gleason 9 (4+5) with mets to liver and lung. His case has been so odd bc he was initially old no mets and went for surgery consult, then told surgery not an option bc it had spread to bladder neck and possible bone mets. RO ordered more scans and said no bone mets but one spit on liver and one spot on left lung. MO ordered biopsy which confirmed PC met to liver so Taxotere started. He left hospital on Casodex after dx and has received two Lupron injections so far. Taxotere round 2 is today.

Appreciate your input so much!
Posted 12/9/2016 6:26 PM (GMT 0)
That is an unusual presentation., Unfortunately, some of the most virulent types of prostate cancer put out low amounts of PSA. Did the pathology report offer any clues about what type it is?

Where are you located? In the US? There is a large US NIH-funded trial called "NCI Match" where one can submit tumor biopsy samples and they will do a genetic analysis of it in the hope of finding rare types that might respond to available medicines. Currently the only such medicine I'm aware of for PC is a PARP inhibitor. But since it doesn't cost anything, and you already have the biopsy tissue, you have nothing to lose. The following link has a list of trial sites all over the US where they can receive tissue samples:

/www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=773118

Another thing worth considering is participation in clinical trials. I suspect that the combination of chemo and immunotherapy will be very effective and complementary. The only immunotherapy currently approved is Provenge, but it is only approved for men with rising PSA after hormone therapy. You can try to get insurance approval based on the current spike in PSA perhaps? Otherwise there are clinical trials of ProstVac or Keytruda that he might qualify for. It may be worth discussing with his oncologist.

To input a signature, click on "My Profile>Edit Profile" and then type in his info. Then check the box "Include Signature" when you post. Sometimes it takes a few hours for it to show up.
Posted 12/10/2016 4:37 AM (GMT 0)
Thanks Allen! I tried to add the signature again so we'lol see if it shows up this time!

The path report said adenocarcinoma, which I understand is a common prostate cancer, although I'm gathering that there may be different types of this? We were puzzled by the atypical path to the liver and lung but someone suggested to me that since there was PNI present that it could end up anywhere. And my dad said he has had the lung spot (plus more) show up on scans before as he's had histoplasmosis, so he's not convinced that its mets since no biopsy was performed on that one.

Second round of chemo went well and he came to my daughters ballgame tonight. Continues to look great, appetite great, no weight loss, coloring is great. He said if it weren't for the weakness from the chemo, he couldn't tell there was anything wrong. So we'll count that as a blessing and hold our breath to see what the next set of scans show. Scheduled for two weeks I think.

Thanks again for your input!
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