I've been on Abiraterone for two years to deal with residual PCa in what remains of my urethra after bladder and prostate removal three years ago. Some might say (my Oncologist does) that it is metastatic. I think it is local (no mets elsewhere and no PCa in any of the bits removed) but not spotted when the surgery was done. Anyway, for eighteen months, my PSA was well controlled at around 1.2. For the last six months or so it had been creeping up and reached 2.8 a month ago. I was resigned to having to go on to chemo next.
On my visit to the Oncologist yesterday, I was astonished to find that it had dropped to 0.9, lower than it had ever been whilst on this treatment and better than it has been since February 2013. How could this be? Well, I can only put it down to a bit of diathermy I had in a urethrascopy a month ago for which I had been pressing to deal with intermittent bleeding from my urethra. I had tried brachytherapy a year ago to fix this, without success.
I learned yesterday that the diathermy was done with a heated roller ball and not the hot wire loop with which I was familiar in bladder cancer treatment way back. Could it be that the heat treatment killed off the PCa in sufficient scale to make the difference I noted? Could it be that the heat treatment affected the particular PCa resistant to the Abiraterone, rather than more generally? Might this type of heat treatment be more generally applicable to other survivors?
So it's curiosity! I guess that future PSA tests may reveal a little more as will any progress on the bleeding, which, so far, has been unaffected by the treatment, but I'm well used to wearing little ladies' drip pads which save staining to my underwear.
Auld Codger (formerly Old Codger, but I couldn't get the site to accept a change of email address, so had to start again!)