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PSA going up fast after 9 years

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Posted 6/17/2023 7:54 PM (GMT 0)
Hey everyone. It’s been a while since I’ve been here. My dad was diagnosed almost ten years ago. He got radiation and Lipton but stopped lupron quickly as side effects were not good. Nine years of testing and no change in PSA. In the last seven months we’ve seen his PSA go from 0 to 1 to 2 to 4. Yesterday he just did a test where they inject him with some dye and it’s supposed to show if there is hot spots? Not really sure. We always knew it would come back at some point. He’s taking it well. He’s going to be 83 in a few weeks. Anyone else have a comeback like this? Trying to see what kind of treatment options he’s gonna have given his age.
Posted 6/17/2023 10:33 PM (GMT 0)
See if he can have that PSMA/CAT scan, shows any prostate return.
Posted 6/18/2023 12:02 AM (GMT 0)
They do have a pill form ADT now, and your father might respond better to that then he did to lupron. I guess it all depends on his psa and his recent test as to future treatment. Your dad is nine years older than me, and I am not sure what I would do at that age.
Michael
Posted 6/18/2023 12:13 AM (GMT 0)
Hopefully he is getting the newer PSMA PET/CT scan that can detect prostate cancer cells at lower PSA. If not, he should insist on it. Isolated sources of the PSA can be targeted depending on location and just a few of them.

My Dad is 95 and had brachytherapy about 20 years ago, he had a recurrence 13 years later which was treated with Lupron for 2 years and PSA was undetectable. His PSA was accidentally obtained last year and it was 9 and the least of his medical problems.

Your Dad’s doctors should find ways to kick this down the road a number years so stay positive.
Posted 6/18/2023 1:10 AM (GMT 0)
Casodex has less side effects compared to Lupron. Its an old therapy but it can help delay progression for a while.

As others have said there is a “new” lupron replacement in pill form called Orgovyx. Its pricier compared to Lupron but the side effect profile is reduced. Also if the side effects get to be an issue its easy to stop taking the pills.
Posted 6/20/2023 5:56 PM (GMT 0)
Orgovyx for fewer side effects.
If that isn't effective in stopping/lowering the PSA then Zytiga or Xtandi, maybe radiation if scans show very few mets.
Posted 6/22/2023 3:44 PM (GMT 0)
So met with oncologist today and show spread to lungs and lymph nodes. Now set up for a bone scan. They didn’t mention any treatment plan as of yet. Very confused. Seems to be an aggressive spread. Not looking good. Am I wrong? Can this still be treated? I understand not cured but can it be slowed down?
Posted 6/22/2023 5:35 PM (GMT 0)
Yes it does appear to be aggressive, but most of us on this forum have been at that point on this journey. After the scan they will discuss treatment options for your father. It could be zytiga, or xtandi or even chemo. Again, I am not sure what I would do at your father's age. Keep us posted.
Michael
Posted 6/23/2023 6:03 PM (GMT 0)
Thanks everyone. This forum is very helpful and supportive. I enjoy the hope that comes from this place. I had a talk directly with the oncologist and got a bit of a change to the diagnosis. The pet scan showed spread to lymph nodes, lower back and seminal vesicles. His latest PSA was actually 16. So it’s moving fast. We are now waiting on a bone scan. He hasn’t had any form of treatment since 2014. Should they not be giving him some sort of ADT or something until the scan if it’s moving that fast? Again, I’m very confused with all this.
Posted 6/23/2023 6:24 PM (GMT 0)
My guess is that the oncologist will move quickly once the scan is completed. They might suggest adt with other meds and it will be important for your father to discuss pill form adt, orgovyx, with the doctor. He did not like the side effects of lupron, which he discontinued ten years ago. If someone told me at the age of 73 that I would live another ten years, I would have done what your father did. He likely has some difficult choices to make in the coming days and weeks.
Michael
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