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Should PSA over 4 be a concern during treatment

Hi, I'm JohnDavid

First the details.

I was diagnosed with Stage 4 prostate cancer in late Sep 2018. My Gleason score was 9. The cancer had metastasized to my bones, from my skull to below my knees, especially in my pelvis, spine and ribs. No surgery was done to remove my prostate because of the extent of my cancer. On Oct 2 my PSA was 152. I started Lupron on 9 October and Zytiga a week later. On Nov 13 my PSA was 33.8. In early Jan my PSA was 4.786. In early March my PSA was. 4.760

I’ve had 29 radiation sessions, ending in January, to relieve bone pain.

My full body bone scan just done 15 March showed no significant changes since the first full body bone scan down in September. So, the cancer has not spread further since my treatment was started.

Given the dramatic initial PSA drop from 152 to 33.8, then from that to 4.786, I’m disappointed my PSA hasn’t gone lower. I’m trying not to be discouraged. My doctor says “we’re in good standing and would like to see it drop further after this plateau”.

The scores I’ve seen here and know of other men with stage 4 prostate cancer are typically 1 while under treatment. I had hoped to be near 1 by now to help indicate the Lupron and Zytiga are fully effective.

Has anyone had problems with their PSA getting below 4?

If you have PSA above 4, has your doctor expressed concerns?

  • Post #1
  • Thu Mar 21, 2019
Hi, I'm Paul S

How old are you?

  • Post #2
  • Mon Oct 7, 2019
Hi, I'm JohnDavid

66 on Sunday. Since my post my PSA continued to rise, had scans showing progression of cancer, tried Xtandi which didn’t work, and will start Xofigo this Friday. That’s my current status. I’ve been feeling pretty well. I’ll be interested to see how things go with Xofigo.

  • Post #3
  • Tue Oct 8, 2019

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