PSA Rise & Progression after Triplet Therapy - Anxious

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Good morning everyone, 

My father (68 yr) was diagnosed with PC in June 2023 de novo (stage IV, Gleason 9, mets to lymph nodes and spine, PSA of 800+ng/mL). He started hormone therapy immediately, then completed 6 rounds of docetaxel chemotherapy, and has been on Darolutamide (Nubeqa) since Aug 2023. His response to treatment was great and his PSA dropped from 800 ng/mL to its lowest which was 0.1 ng/ML which he achieved in October 2024. 

Unfortunately, in February 2025 we got news that his PSA jumped up to 3.43 ng/ML. He completed scans which showed that his bone mets had progressed, particularly around this thoracolumbar vertebra. Dad has also been experiencing increased back and hip pain since the beginning of February, particularly at night. After a recent meeting with his oncologist, the plan is to continue taking Darolutamide and HT injections, and to start a new chemotherapy called Cabazitaxel (Jevtana) on April 1, 2025. 

We are still in a bit of shock as we were not expecting Darolutamide/HT Therapy to start failing only 18 months after starting. In any event, I am posting here today for any advice/support from people who have experience with a similar timeline to my dad's. I am anxious, as it seems that castrate resistant prostate cancer does not always have a very favourable prognosis. 

Regards,

Johnny 

  • Hi Johnny, and a warm welcome to the forum, though I'm so sorry to hear about your dad, though I'm similar to your dad stage 4, Gleason 10, with mets to lymph nodes, organs and spine, and castrate resistant and low secreting, due to comorbidities, chemotherapy is only a last throw of the dice or me, but can I suggest you put your question to the wonderful guys and girls on the prostate cancer forum, an amazing bunch of people, who will be happy to share their knowledge and experience, and many in a similar situation to your dad, best wishes.

    Eddie

  • Hello Johnny ( 

    A warm welcome to the Macmillan Online Community - although I am so sorry to find you here. I am Brian one of the Community Champions here at Macmillan.

    The Community is divided up into cancer specific forums or chat rooms and to get the best advice from people on the same or similar journey as your father I would advise you to join the Prostate Group - here's the link you need:

    Prostate cancer forum 

    Once the page opens up click on "join" on the black banner at the bottom of the page. Once you have joined the group you can then either copy and paste or repost the post above in the "New Here - Say Hello" section. I can assure you of a warm welcome on the group and plenty of answers - I should know I am in my 4th year of my own prostate cancer journey.

    I look forward to "meeting" you again in our own part of the Community. If I can do anything else for you please do let me know.

    Best wishes - Brian.

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