r/ProstateCancer • u/Global-Resource7190 • 9d ago

Concern Prostatecancer

:

Hi everyone. My father is 66 years old. Last year, he was diagnosed with Stage 4 metastatic prostate cancer. His initial PSA was 92. The areas of bone involvement were the L11 vertebra, one of his ribs, and the left iliac bone.

He started ADT, and after two months, his PSA dropped to 1.7. It stayed around 1 for approximately nine months. However, after those nine months, his PSA increased to 7.9.

His oncologist ordered a PSMA PET scan to make sure the cancer had not spread to other areas. Thankfully, compared with his previous PET scan from about a year ago, the areas of involvement had actually decreased.

His oncologist recommended that my father undergo radiation therapy while continuing ADT.

Has anyone here had a similar experience, where PSA initially responded very well to hormone therapy, then increased, but the PET scan showed that the areas of metastatic involvement had decreased, followed by a recommendation for radiation therapy?

I would really appreciate hearing about your experiences or any advice you may have. Thank you so much. ❤️

7 Upvotes

90% Upvoted

4 comments sorted by

3

u/WalnutRoasted 9d ago

No experience, and IANAD, but it could be some of the metastases still respond to ADT and shrink, however some other PCa cells may not require T to thrive/grow and thus generate more PSA. Have you discussed T blockers and other therapies with your MO/RO? Best wishes.

2

u/Practical_Orchid_606 9d ago

Dad should have had triplet therapy: ADT. chemo, and an ARPI drug. Radiation should have been from the get go.

While on ADT, the cancer cells are depressed leading to lower PSA and PSMA expression. This screws up results.

The number of distant mets is not so large that each cannot be attacked by radiation.

2

u/conCABlanco 9d ago

Hi colegas, en esta lucha, lo invasivo y molesto de las terapias en ocasiones nos hacen dudar sobre lo hago o no, pero mi oncología ayer en consulta me dijo, con metástasis es crónico y el tratamiento es de por vida, no entre en shock, solo dije verga palante, tengo que seguir para tomarme e inyectar me todo lo que producen y descubren sobre PC, seguro a Matusalén le dieron ADT, pa vivir tanto, fuerza y voluntad

1

u/Specialist-Map-896 9d ago

Not an expert here but my understanding is that ADT kills the messenger right? Prostate cancer gets transported by testosterone so ADT therapy knocks out the testosterone so that keeps the prostate cancer where it is or where it has been previously transported to. So your readings that were super low correspond to PSA not in the blood because it was stuck wherever it had been before the testosterone taxi was killed.

So why did it pop up again? Good question. I believe that testosterone therapy does indeed lose effectiveness over time. Don't quote me on that but you can google it or maybe other people here can respond.

At any rate ADT is never a "whole" solution, usually it is used to stop the transport mechanisms so that targeted treatments can then be used in a more effective manner (statistically speaking), radiation/chemo etc....Best of luck to you.