Apalutamide (Erleada) for a year but PSA is now rising

Posted by cal77 @cal77, Apr 6 2:38pm

I've been on Apalutamide for a year. PSA went down to 2.3, but the last couple of months it's going up...
I thought Apalutamide was supposed to keep PSA at a level of 0.1...I had been hoping it would decrease and not increase..
It's up to 4.0 now.

Anyone else have this happen?

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Did you have distant mets when you started taking Apalutimide? Also, had you been on any type of ADT for an extended time before starting Apa?

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I was on Erleada and ADT 6 months prior to and post RP and it has worked. I am 17 months with no med . If I were you I would talk with my urologist about ADT & Erleada and chemo and try to knock this cancer down. Good Luck

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@russ777

Did you have distant mets when you started taking Apalutimide? Also, had you been on any type of ADT for an extended time before starting Apa?

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I had Stage 4 metatasasized to bones...Put me on Apalutamide and Erleada...PSA was going down, but now at 6 months , it is going up...
See the Urologist in 2 weeks..
Just wondering if this is normal to go up...It was at 2.4 in December last year and now going up every month..

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I was on Xtandi for a year then PSA started doubling as it stops working

They were going to put me on chemo but since only in bone I got approved fro Radium 223 or Xofigio google that Injection every 4 weeks for 6 months
Only for bone mets Lu 177 for all cancers
They added Xgeva every 12 weeks I also take calcium 600 mg dailu with D and K
Zolodex every 12 weeks

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So far (2 1/2 years) on ADT and Erleada (Apalutamide), my PSA has remained undetectable with the ultra-sensitive test, but I know that can change at any time. I have stage 4 PC with one bone metastasis, and have had two rounds of SBRT radiation (one to the metastasis site and one to the prostate itself). No chemo yet.

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@cal77

I had Stage 4 metatasasized to bones...Put me on Apalutamide and Erleada...PSA was going down, but now at 6 months , it is going up...
See the Urologist in 2 weeks..
Just wondering if this is normal to go up...It was at 2.4 in December last year and now going up every month..

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Hi Cal77, I thought that Apautamide and Erleada are the same medication. I was on Erleada and Orgovyx for 6 months, I had radiation at the 3 month point to a single metastasis (Lymph node in my chest). PSA was 13.46 before those treatments [RRP 24 months prior followed 6 months later by 34 rounds of salvage radiation to the prostate bed]. Three months into the latest treatment PSA was undetectable at 0.01 at 6 months on Orgovyx and Erleada PSA was still at 0.01 Three months after stopping both drugs PSA was 0.02 one month later up to 0.08, at now 6 months after stopping, PSA at 1.02 But the good news in all of that is all of my scans were stable, PSMA/PET scan, CT scan and Bone scan all we "stable". More treatments soon to come...
So to answer your question; no, I don't think that it is normal for your PSA to go up while you are on ADT. I also don't think that it is normal for your PSA to start climbing weeks after stopping ADT. Do you have an Oncologist as well as a Urologist? You may want to consider adding an Oncologist to your team if you do not have one yet. Neither my PPC nor Urologist recommended that I get a Oncologist. But I decided myself to find the best one I could in the area. Then asked my Primary Care Physician to give me a referral to the one I chose, which he did.
I think that everyone's situation is unique with this disease. But there comes a time that the expertise of a Clinical Oncologist is something to consider. I think it was the best thing I did and feel like I am getting better care and given more options than my former urologist was able to provide.
I wish you the very best.
Stay strong!

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@northoftheborder

So far (2 1/2 years) on ADT and Erleada (Apalutamide), my PSA has remained undetectable with the ultra-sensitive test, but I know that can change at any time. I have stage 4 PC with one bone metastasis, and have had two rounds of SBRT radiation (one to the metastasis site and one to the prostate itself). No chemo yet.

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Look at Xtandi If you can get on Radium 223 or Xofigio for bone mets I am on 4th injection 79 and feel great

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Something like that is the plan if/when there's any sign of progression. Right now, there's no indication that cancer is active anywhere in my body (though I know there are probably dormant cells hiding out somewhere).

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