PSA and Chemo

User

Posted 10 Feb 2015 at 14:14

Hi all,

My husband was diagnosed with aggressive prostate cancer June 2014. His PSA was 7.4, Gleason score 10. The cancer had spread to his spine, a rib and seminal pouches. After a few hormone injections his PSA dropped to 1.1. In October he started having problems passing urine again and his PSA had started to rise again. The oncologist arranged a course of radiotherapy to start 1st of December 14 but bat the end of October his bladder became distended and he ended up with a catheter.

He got his radiotherapy, every work day for four weeks. At the end of the treatment he developed a pain in his right hip and was prescribed painkillers.

His PSA was checked at the end of his treatment and it was 7.4, it was checked again last week (5weeks after treatment) and it is 13.8.

We seen oncologist this morning and he said given it was aggressive cancer and the fact his PSA was rising and he had hip pain he was certain the cancer had spread to his hip. Hechas to have a bone and CT scan at the end of March and then see oncologist in April. If confirmed it has spread he will be given chemotherapy

My question is, how successful is chemotherapy and why is PSA of 13.8 bad when people can one in the 1000s.

Thanks

Senga

User

Posted 10 Feb 2015 at 14:25

Forgot to say he is getting three monthly hormone injections decapeptyl and bicalutamide 50mg daily

User

Posted 10 Feb 2015 at 16:10

I am sorry that you find yourself here in such circumstances. Unfortunately, there is not a direct correlation between PSA levels and PCa, although it is very strong. We live in hope that a more accurate measure is found, and that men can be tested just as women are for breast cancer. Until that day comes, sadly, men will continue to find aggressive PCa when the cancer has broken out of the prostate.

I cannot comment on how successful any treatment might be - there are others who have the experience and knowledge to give you answers.

Stay Calm And Carry On.

User

Posted 10 Feb 2015 at 18:47

Hello

The question you ask has bothered me throughout the time I have been a member of this forum. In our case hubby had a PSA of 25 and is a Gleason 10 too., plus spead to hips and spine. However, we have been on this journey for more than 4 years now and still are waiting for the PSA to rise high enough to start chemo. Why has my hubby had such a successful journey and others, with lower Gleason scores have not? I guenuinely feel this is a mix of genetics and they type of PCA you actually have (at last count there were at least 24 types of PCA). I can only conclude that my hubby has an indolent type, despite the high Gleason score.

It's such an unpredictable disease. Our oncologist goes primarily by symptoms (once on HT) as he see this as a good indication of what's happening. I rather agree as we have had men with a PSA of less than 1 who have spread to soft tissue and organs and others with PSAs in the 100s with no spread.

For myself, I'd rather my hubby had chemo whilst he is well, but at the moment he has just had 20 Grays of Radiotherapy to his hip to contain the worst tumour. The oncologist is saving the chemo for another day.

Good luck with treatment, many people here have had chemo and most have found it bearable.

Love Allison

User

Posted 10 Feb 2015 at 20:34

" My question is, how successful is chemotherapy and why is PSA of 13.8 bad when people can one in the 1000s."

Broadly speaking chemo is successful in producing a lasting remission in about a third of cases. Another third get some response but it doesn't last very long. Maybe a few months. The final third get little or no response except perhaps for pain relief ( if there are painful mets.).

Sometimes the chemo does seem to allow another round of HT to be helpful so although the chemo may appear to have done little, some help is seen with HT afterwards.

As the P.Ca. mutates, particularly in an aggressive case ( e.g. Gleason 10 ) sometimes the offspring cells produce little or no psa. Thus psa figures become less relevant and scan results and symptoms become the guide to treatments chosen.

"His PSA was checked at the end of his treatment and it was 7.4, it was checked again last week (5weeks after treatment) and it is 13.8"

It is possible that the R/T caused a flare in psa figures. As R/T takes effect this has been noted.

Sounds like the scans have been scheduled to give the R/T time to take best effect. And will thus give a clearer picture.

Hope this clarifies a bit more for you.

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