Puzzling PSA increase

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My husband (Gleason 9, aggressive PC) was started on Abiraterone in Dec 22 after the Bicalutamide had stopped working.  His PSA immediately reduced and stayed around 0.9 until Jan this year, when it started to rise again.  Due to his review being cancelled in April he wasn’t changed to another HT and didn’t have another review until July, by which time his PSA had increased to 40.  His consultant changed the Prednisone to Dexamethasone and spoke about possibly changing the Prostap to Zoladex.  He also arranged for bone and CT scans, both of which were reported as clear with no spread. 

He had another review in August, by which time the PSA had risen to 61.  His consultant was mystified as, although the PSA has risen steeply, his testosterone level had reduced from 0.9 to 0.4.  He decided to leave him on Prostap and Dexamethasone for now but ordered a full MRI and another bone scan, as he’d since seen something on the previous one which could after all indicate a slight spread. 

Well, it’s rather worrying when a consultant doesn’t even know what’s going on!  We’re now awaiting his MRI result with some trepidation, while he’s awaiting his bone scan appointment in October.

  • Hi Haze, I understand how co-morbidities and other significant conditions influence your treatment options only too well, I have 17 plus APCa in 15 places, limited to HT (failing) and RT,  but  with options to come and I'm sure there will be options for your husband too once the MRI results are known, best wishes 

    Eddie xx 

  •   Ahh, good that you both happy with your hospital and treatment. It can be such be a worry being the partner/wife of someone unwell, remember to look after yourself as well. Let us know how you get on. 
    L

  • Hi Prostate Worrier, and apologies for delay in replying.

    We ‘met’ back in June when my husband was worried about getting more meds to take on holiday.  It was close but all was well in the end.

    I’m sorry you’ve had to have RT on your pelvis and hope that it’s had a good result. 

    It must have been a terrible shock to suddenly be given a PSA result of over 1000 when you were first diagnosed!  (I have read of others getting a result of 1000+ but it always seems to come right down once they start treatment.)  At least my hubby’s was only 12, but he was forewarned about the possibility of PC due to it being hereditary in  his family, and getting regular PSA tests so it didn’t come as a great shock to him, unlike a lot of men.

    It will be interesting to find out the result of the MRI in October.  He says he’s feeling quite well in himself at the moment and even his back problems unrelated to the PC haven’t flared up recently.  

     Haze

  • Hi Eddie,

    I’ve been reading your profile and seen the number of health issues you’ve had to fit your cancer treatment round.  Reading the comments in this forum it seems my hubby has had it quite easy so far.  He was first diagnosed at 57 but at least it took another 8 years to return enough to need further treatment.  It’s pretty shocking to be given a prognosis of 5 years at your age.  I do hope they can find more options for you to extend that time.  They always seem to be coming up with some new treatment these days.  Best wishes, Haze

  • Hi Chocoholic28.

    Many thanks for your reply please don't worry about the delay!!!

    Yes at present the RT seems to have done the trick and long may it continue.

    Yes everything was dom and gloom when we heard the words 1000+ and everyone expected the worst.

    I do hope that everything goes ok for you both going forward!!!

    Prostate Worrier.

  • Thanks Haze, for your good wishes, I don't think anyone has an easy ride with cancer. I will find out what my options are on Monday at my MDT meeting, PS my profile is out of date, my latest scan on the 16th shows more mets and my PSA is 3.42 up from 1.04 which being intraductal and low secreting and having 3 cancer types is concerning, I think 5 years is also out of date now. but there is a little hope. though my focus is on my daughters cancer, we've just been for RT No7 of 10 with surgery to follow and a little hope of cure, as I'm sure you'll understand kids come first. best wishes with your hubby's results and treatment.

    love Eddie xx