What treatment next?

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User

Posted 11 Jun 2019 at 18:51

not posted very often, but would like some advice if some one can offer.

My husband diagnosed last Aug, PSA 320, G9 3 bone mets. Had Lupton straight away, then 6 cycles of Chemo (Taxotere) now on 6 (one weekly) Radiotherapy, PSA went to 1.5 late Dec, then went up to 2.1 in March, will go for another blood test next Fri, and see Oncologist on Monday.

My question, if his PSA has risen again (IF) what will the next line of treatment be.? Will they add another drug, (Zytiga) or will we have to wait another 3 months to see if his PSA has risen again (all a bit stressful)

I want to be prepared, as to what questions I need to put to the OC, and can I FORCE him to do this, or do I just have to do what 'he wants' as its ont he NHS?

User

Posted 11 Jun 2019 at 20:34

I don't think you will be wanting to force the onco to add another drug - each drug only lasts for a finite amount of time so they may not want to add anything until the PSA gets quite a lot higher or the doubling time gets much shorter. Some oncos would advise waiting until the PSA gets to 10 or 20. Others would say do it now.

Whether it is abiraterone or enzalutimide may be down to onco preference or could be determined by any other medical conditions your OH has.They may suggest chemo again if he tolerated it well last time.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 11 Jun 2019 at 22:23

Thankyou Lyn for your informed reply, r ead recently in the Latitude results that if they start abiraterone sooner rather than later, it can delay Cancer progression by 18months and reduce mortality by 38%, for high risk cancer along with ADT.

I know im panicking about this up coming PSA test, but surely keeping the PSA ultra low is what its all about.

I would like to reserve chemo again for later on.

As my husband has an aggressive G9 stage 4 im constantly worried that its creeping back already, as the PSA rose in the 3months, I know only slightly but still.

Once again thankyou for your input

User

Posted 12 Jun 2019 at 00:56

Originally Posted by: Online Community Member

surely keeping the PSA ultra low is what its all about.

I don't think that is what it's all about. More important that the medics can spot the optimum time for adding / stopping meds. Add it too early, the options run out earlier. Add it too late, the man may not be well enough to benefit.

At the minute, the doubling time isn't too bad. He is having RT which can raise the PSA temporarily and has fairly recently had chemo which can also play havoc with the PSA. Think of it as the cancer cells screaming as they die. Basically, at the minute the PSA reading isn't a reliable indicator of whether the hormone treatment is failing. Do you get his testosterone level tested as well? That would be a useful indicator for future monitoring.

There is no harm in asking about adding abi or enza when you go to the next appointment. It doesn't seem like you have an onco who sticks rigidly to NHS guidelines or only offers minimum treatment - if that was the case, your OH wouldn't be getting RT.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 Jun 2019 at 17:13

thanks, will ask about testosterone levels when we go next week.

Once again thankyou for your detailed response, very grateful for your knowledge for us newbies here.

Just makes us look a bit more informed when we see the OC.!

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