What comes next?

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My PSA is beginning to rise and is now 0.44. I was diagnosed nearly 5 years ago. Gleason 10. So started 6 sessions of docetaxel and 20 radiotherapy sessions. Then Prostap every 12 weeks. So I think I’ve done well. Next treatment is probably Enzolutamide plus Prostrap. Im hoping this will reduce PSA and keep me safe for some time. Looking ahead just wondering about options after this. Is it some nuclear isotope or some other combination of drugs?  I would like to hear from others on this journey  I am reasonably well and pain free so I am thankful for my care  Stanley

  • Hi Stanly - I am glad all is well with you. the general rule about PSA:

    * You reach your lowest level (nadir) 18 -24 months after Radiotherapy has been completed.

    * There could be a PSA bounce in the first 2 years where it rises and falls but this is normally in younger men.

    * The signs that the cancer has returned are:

    1 - Your PSA rises 2 whole points above your nadir level.

    2 - Your PSA level rises in 3 tests in a row within 6 months.

    From your post above, I think you need to keep an eye on the PSA figures but at present I don't think you need to panic - but saying that I am not a medical person - just letting you know what I have been told.

    I hope this helps and that you are re-assured.

    Kind Regards - Brian.

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  • Thanks Brian for your reassurance 

    I'm down for a PET PSMA scan soon so the oncologist wil know about any spread from the tumour on my rib. There seems to be a lot of drug combinations which are giving good outcomes. Choosing the most effective one and what order to take them in must be difficult 

    stanley

  • Hi Stanley

    It's a strange one this PC - we all have it but our personal journey is so different to everyone else - the combination of drugs and treatments now for the use of urology and oncology is amazing. 

    The one cheerful statistic is that 98% of people with prostate cancer die of something else!!

    I hope the results of your scan are good and that there is no spread and your PSA remains low and steady.

    Kind Regards - Brian.

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  • Hi Stanley

    Coming up to seven years myself, Arbiraterone and enzalutamide are the next steps, which will keep you going for a few years, then there’s radium 223, plus Chemotherapy again, plus some new medications that are trialing. My PSA has jumped up to 14 so I might have to try a new medication as I’m on enzalutamide I always ask for a plan B which will be chemo or something else.

    Stay safe

    Joe

  • Thanks Jo. Just my thoughts. It’s good to know you’ve been kept going for seven years being treated. My oncologist always reassures me there’s plenty of options out there. I hope you are coping well with the side effects. 
    stanley