Hi all,
Just a quick update on this - Dad had the scan results today with his oncologist, and it's fairly positive news - the scan was completely clear.
In his Feb scan, there was no sign of activity on the bones (i.e. no mets picked up by the scan) but with some small number of cells remaining in the prostate. This time his scan showed that his prostate was also clear, as well as his bones. So this scan was in fact even better despite PSA being <0.01 then and higher now. Big relief - especially since the Oncologist said the scanner used at this hospital was highly sensitive/accurate, so the fact it picked up nothing was very reassuring. (I'm guessing the explanation for this may be that at the time of the Feb scan, the effects of the chemo were not entirely complete yet)
No suggested changes to treatment (which consists of daily Darolutamide and obviously HT injections every 3 months), for now at least.
The concerning part was - as discussed previously the PSA is slowly creeping up since June - from undetectable in the Spring (<0.01) up to 0.4 in early August. The good news here is that last week's PSA test was 0.26, which is obviously a decline from 0.4 two months previously. This came with no change in his treatment - so maybe suggests PSA could perhaps be stabilising - for now at least? We'll need to see what subsequent readings say, as it does seem like these things can fluctuate, and the trend could easily continue upwards.
The oncologist's view was that they'd want the PSA to be <0.01 and there's something that must be causing this for it not to be at that level, so they're going to remain keeping a close eye on him. He'll continue having PSA tests every 2 months, as he has been, and they've said they'll give him another scan in 6 months' time.
One thing I was wondering (and would be interested in views regarding) is whether we should be looking at his testosterone level? From reading I did a few months back, I got the impression that sometimes testosterone not being suppressed quite enough can cause these sorts of numbers and maybe we should check in case it could be lower. I don't have this data but I'm sure they've tested this.
Alternatively, perhaps this is just what a slow, gradual progression to castrate resistance looks like. After all, his diagnosis was a Gleason 5+4 (i.e. very aggressive and not generally a good prognosis), and obviously controlling metastatic disease is (in most cases) fundamentally about slowing progression as much as possible - not everyone can stay undetectable for years of course, even on the best treatments. His treatment regime has clearly worked very well and even now his initial treatments are still holding up, with plenty of other options left on the table when they eventually fail. Trying to remain grateful for that - with a diagnosis like his, things could have been far worse by now.
Overall, I still think this is quite positive, and we're taking some comfort in these results. Dad is understandably still anxious. If nothing else, though, we're definitely reassured by the quality of his care - they're being very proactive about keeping on top of things, and we're very grateful.
Edited by member 04 Oct 2024 at 23:34
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