My husband was diagnosed with Advanced Prostate cancer in March 2023. Extensive bilateral adenocarcinoma.
His PSA at this time was 3712.
Gleason score 9 (4 + 5)
Likert score of 5. PSA Density 92.5 T3b N1 M1
Possible involvement of the apex of bladder
Scans showed spread to multiple abdominal nodes and bone metastasis in ribs bilaterally, iliac bones of sacrum, right public bone and right acetabulum. Patchy activity throughout thoracic and lumbar spine which may be degenerative rather than metastatic. Changes noted right hip and sternoclavicular joint also.
He was commenced immediately on Degarelix injections and has just completed 6 sessions of Docetaxel (80% strength because of increased risk of neuropathy)
He has also had Zometa with each chemotherapy.
His PSA fell rapidly initially but has now plateaued. His current PSA is 170.
Our Oncologist has told us that he does not expect PSA to fall much further, but the important thing is to keep it from rising again, looking particularly at its doubling time.
He will have another PSA in 3 weeks time, then further bone scans and CT scan in January before reviewing situation in February.
Our question is:- With PSA still so high after chemotherapy, does this affect prognosis or have others managed to retain PSA for some time without rising.?
We have talked about next lines of treatment, so are aware there are still options.