Rise in PSA

Hi skye_saturn !

Sad to see that your father is not progressing as hoped and I truly understand that you want to do everything possible helping him.

There are lots of fantastic people in this community that are able to give very good advice. Well, anyway if I understand you correctly your dad is on ADT since a year ago but now the PSA is rising again correct? Has your father been tested to see that his Testosterone level still is suppressed to a good chemical castration level? Sometime you can add 2nd gen treatments like Abiraterone to the ADT. I’m not a expert but; Abiraterone helps out in blocking for example the prostate gland producing its own Testosterone and I think it’s a rather standard combination to really try to starv the prostate cancer of Testosterone and put it back into remission.

I myself is on ADT and Abiraterone and my Testosterone levels are almost not measureable and the prostate cancer is not in a good shape being starved on Testosterone.

Just a thought and I think you will have a lot of good ideas from different members that you then can ask your fathers MO.

Best wishes - Ulf

Hi skye_saturn . Many thanks for the update but I can understand your concern at the rise in the PSA and your dad's feeling fed up. Your oncologist is keeping on top of things and, if possible, I would push for a PSMA PET CT scan which is the most sensitive one available at the moment. Once they have identified where the cancer is lurking then this can help direct the appropriate treatment. I can't remember if your dad is on any hormone tablets as well as the injection/implant but if he isn't then this would probably be the next thing they will add in - these are second generation antiandrogens such as Enzalutamide, Apalutamide, Darolutamide and Abiraterone. If there are just a couple of mets then they can offer targeted radiotherapy. There are also systemic treatments available so plenty of tools in the toolbox. From a personal point of view my husband has had 3 recurrences in 4 years so I do understand how draining it can be but after his last treatment in April he is now in the best place he has been since his diagnosis in July 2020 so stay positive for your dad. Looking to the future I would get your dad to ask for a genetic screening of his biopsy cores as this can guide the experts to choose treatments which are most likely to work for him.

Lymphodoema is a side effect and my husband experienced this after both radiotherapy and chemotherapy in one leg. Exercise is good for it generally. If you want any help on how to deal with it then just ask but it is important to only gently massage the affected area.

All the best and please come back with any questions.

Hi skye_saturn , sorry to hear your dad’s PSA is going up.  You have already had some good info so I won’t repeat that.  You sound to be a very caring daughter and I am sure he appreciates that already.  The whole process does unfortunately revolve around appointments and treatments, so anything you can do to lift his spirits will be beneficial.  My oncologist jumps if I mention a holiday and almost insists that I go!  Anything to distract from the current routine and raise morale will be worth doing. Best wishes, David