Metastatic prostrate cancer

Hi

Sounds like your current HT is becoming hormone resistant so I would expect them to change your medication to control the disease. There are a number of protocols available to treat hormone resistant disease so stay positive and I'm sure others on the forum with more direct experience with this will step in to help.

All the Best and Happy New Year

Rob

Hello Ro811  A warm welcome to the online prostate Cancer Community

I am so sorry to read of your condition. After cyber knife HT is the normal treatment. Your nadir  PSA reading would be the one 18 months after the cyber knife treatment was completed. The usual criteria is that if the PSA rises a whole 2 points above this nadir figure then further treatment is required. If this is the case you should be having a chat with your team. You should have a dedicated CNS (cancer nurse specialist) who would be your first port of call.

To help us help you can I ask you complete your profile with details of your cancer journey. To do this go to your home page, click on the chair in the top right - then "profile" and then "edit". You can read my profile by clicking on my name or the icon of the beach to give you an idea of what to write. (you don't have to write a novel!). This will stop us asking you the same questions over and over again.

Best wishes - Brian

Hi,

I am on similar journey to you but not so far advanced from the sounds of things.  There are treatments, it is not the end of the road!  You will need to discuss with your oncologist but chemo is an obvious option or possibly enzalutamide.

Also if you can persuade them to do genetic screening and you have the BRACA2 gene there is a new treatment, Oparlib I think it is called, which has recently been signed off by NICE.

Don't give up hope, there are still ways forward and there are new treatments coming along all the time.

All the best Steve

Hi.

My husband is also on this rollercoaster of the cancer becoming resistant to hormone therapy. Brian is right when he says that the first trigger is when the PSA rises by 2 above your nadir, but it is also measured by a doubling time within 6 months (I think) or with 3 consecutive rises. Your next step now is to try and get a CT scan to see what is going on, and if necessary push for a PSMA PET scan which should pinpoint if you have mets anywhere else. The problem with the lymph nodes is that they can act as a superhighway for moving tiny bits of cancer round the body. There are different treatments depending on where the problem is and what level of spread there is if any, but also on how aggressive your cancer is. There is a battery of new antiandrogen treatments available which act in a different way to standard hormone therapy so that might be your next step. Chemotherapy has also proven effective. Things like immunotherapy and possibly nuclear therapy are usually kept for further down the line - our oncologist says 'not yet'. I think that Olaparib has only been signed off for those with advanced prostate cancer at the moment so again one for the future.

So you have a lot of alternatives.

Good luck with your journey and come back with any questions.

Hello Again Ro811  - Many thanks for adding some details to your profile. I notice you are a little concerned at the lack of "follow up" from your NHS provider. May I make the following suggestions:

* You contact your team - you should have the name of your consultant or CNS and ask what the situation is with your rising PSA  and what action do they propose to take.

* If you can't get a satisfactory answer from them - contact your hospital PALS team. Patient Advice and Liaison Service - and ask them to sort your issues out.

I hope this helps - if you are still having issues please get back to me - i have more arrows in my quiver!!

Best wishes - Brian.

Many thanks for the info/tips. My nhs doctor has contacted me regarding the psa increase with a telephone consultation on 15th Jan. 

Will wait and see where this goes if no where, I will contact my old Mount Vernon team.....