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PSA rising after 2 months choice of chemo or enzalutimide

User
Posted 30 May 2022 at 18:55

Hi everyone 

My dad was diagnosed with advanced prostate cancer in April. He had no symptoms apart from in January needed the loo a bit more. He has it in bones and lymph’s not organs 

his psa level is ridiculously high ive not seen anyone on here with it as high. It was 7,897 

after having the bicultamide tablets and then his first injection of leuprorelin his Psa dropped to 139 which was a great response. 

After our first scary visit to the oncologist my dad was offered either chemo or enzalutimide. he is fit and healthy for 82 and still very active. But he does have high blood pressure and takes tablets for this. 

we were always going to take a second treatment option. Leaning towards chemo to kill cells and that it’s summer less infections etc. can be more careful. But after todays visit (second one) the doctor really scared us both on the side effects of chemo. Just wondering how people have got on with it? Any major side effects? (Though I know everyone is different) 

He had another psa test today and the bad news is it’s risen to 270 so the cancer has already stopped responding. We are now in 2 minds. Do we go aggressive with chemo try enzalutimide later or do we have just as good a chance on the tablets alone?

my dad is terrified to have chemo and the rising level has been such a shock today. He thinks perhaps he doesn’t have long left :( but surely one of the treatments could still work for him

would be grateful for anyones experiences and stories or even advice. 

 

thank you so much I hope everyone on here is doing well. 

 

User
Posted 30 May 2022 at 21:50

The highest we have had on here was 13000 and we have had a fair few around the 8000 mark. The highest my husband's urologist has ever seen was 160,000!

How do you know the injection isn't working? Have they measured your dad's testosterone? Are you sure that dad's first injection was a 3 month dose and they didn't give him a one month dose to start with, in case of major reaction? Was the onco going to put him on chemo or enzalutimide anyway or is that being suggested because his PSA has risen? Often, if a hormone treatment appears to fail immediately they try one of the other first line hormones before they chuck in a second line.

Having said that, if chemo or enza was in the plan already, it seems sensible to go for the enza first. Charities and patient groups have fought hard for the right to have enza before chemo and I don't think the NHS would ever have given in if it hadn't been for the pandemic

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

User
Posted 30 May 2022 at 22:22

Sorry I should have added that due to dads age the reason perhaps chemo first is that if enzalutimide works for a few years he might then not be eligible for chemo due to age. 

also if has chemo it appears he then has more options down the line. Like a second round, or enzalutimide or radium 223. At our hospital you have to have had chemo to be eligible for 223 

User
Posted 30 May 2022 at 23:04
R223 is not necessarily a deal breaker - a) it doesn't treat the actual cancer, just reduces the side effects of problematic bone mets and b) for some men, it makes bone pain much worse rather than better.

If he has enza first, that doesn't rule out having chemo twice in the future. Whichever order he has the treatments, the same treatments will usually be offered at some point. If he has chemo first, that is a whole summer of not really being able to go anywhere or enjoy anything much - I think if it was my dad, I would want him to have the best summer possible and make lots of memories. Having said that, enza is also a form of chemotherapy so he would still need to be really careful about infection, etc.

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

User
Posted 09 Aug 2022 at 00:47

How is your dad doing? 

User
Posted 11 Aug 2022 at 21:38

Hi Searly 83. I have been on Enza since the New Year. The only thing I would say is that increasing the blood pressure is one of the side effects. I was on 3 types to control mine, and after taking the Enza I had to go on to 4types, and now 5. But don't forget every case is different & not everyone is affected the same way.

 
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