PSA rising after only a year on Apalutamide and Erleada

I am sorry to hear your situation. Keep up the good fight! My understanding is that chemo can be effective at killing cancer cells, it has the downside of also killing other cells that are dividing. There are other treatments such as Radium 223 that are specific for bone mets. I have PCA in many lymph nodes and doing ADT. Are you hormone sensitive or resistant?

It is not futile. My father had stage 4 at age 65. He is 85 now. He's had radiation, chemo, hormone therapy, and nuclear medicine over the course of 20 years. Some of it sucked, but he stayed focused, exercised, and ate well. The exercise was particularly good for his body and his emotional state. It's not over for you. Just keep up the fighting spirit.

Oh my gosh I’m going thru the same with my husband now, stage 4 - Apalutamide, several clinical trail and now chemo.
He’s actually in the clinic right now for a transfusion.
Diet and exercise cannot be overlooked as it plays a major role in your recovery and response.
You gave me hope.

"PSA got as low as 2.6, but in the last 6 months has risen now to 8. The Oncologist may do Chemo in November. Is this the beginning of the end?"

I'm sorry for your news. In 2014 they might have said effectively "Sorry, Charlie, we're out of ideas." In 2024, you're still just at the beginning of all the new treatment options.

I hope that's what you're hearing from your care team; if not, seek out a second opinion (or better, a multidisciplinary cancer centre, if you're not at one already).

Technically speaking, you *might* just have transitioned from metastatic castrate-sensitive prostate cancer (mCSPC) to metastatic castrate-resistant prostate cancer (mCRPC). I say "might" because you didn't mention any confirmed radiographic progression yet, and your PSA could maybe still come down under a different ADT+ARSI combo.

Chemo is often a good option, of course, but make sure your care team has discussed all the other options with you, either alone or in combination with chemo, and explained why they are or aren't recommending them.

Best of luck!

I also am stage 4, bones and a couple lymph nodes, At the beginning I had 10 rounds of chemo. Was it rough,sure but I would do it again,(Dr. said I was finished for now) I finished that treatment last october, it's almost a distant memory. I get firmagon shot every month, take Abiraterone and presnidone daily. I forget about the chemo sides, now I get to deal with the sides from these meds. For sure I'm not telling you to go with the chemo, you asked how it is, You can get through it if that is the road you take. From reading what others say on here, I don't know if any the treatments are a walk in the park. Best to you on your journey.

Please tell me what 10 rounds of chemo did to the PSA?

Of course I don't know if it was all chemo but I was at a psa of 932 and now it hangs at .02 Someone else might have a better idea if it was the firmagon or the chemo that dropped it.

My best girl looked up the data for me..March of 23, psa was 936, started on Firmagon. April, psa was at 5.26 still on firmagon. May, started chemo and Firmagon, psa was .46. Taking Abiraterone, presnidone and still get monthly Firmagon, last check psa was .02 Best to all.

Thanks for all the great info. Firmagon must be like Lupron or Trelstar that I m on every 3 months. Your hanging in there after 10 chemo. Treatments- doing good. I m impressed.

The Dr. said I was Hormone Resistant.