At what point was the PSA undetectable

Posted by beaquilter @beaquilter, 2 days ago

Last week my husband had his 4th chemo and has been on ADT both the shot and pills for several months. (Firmagon and Zytiga- he refuses lupron)
the PSA has been lowering from almost 300 initially then finally nose dived after starting ADT but when it hit 4 something then 2.5 it's slowed down a lot, I think 2 months ago it was 4.4, then a while later 2.2 or something and last month 1.5 and now last week it was 1.3.... My husband had hoped it would go in half almost each time but this wasn't much.
The nurse told us it's fine (and I guessed that too) as long as it's trending down!
We were told that at some point when it starts doubling again, even if it's from 0.2 to 0.4 then he would qualify for Pluvicto...not that it's THE wonder drug.... they expect it after 18-24 months on ADT.
I think he's just worried that the chemo is not doing enough, that it's all pointless sort of.

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northoftheborder | @northoftheborder | 2 days ago

The ideal is for PSA to become undetectable, but anything under 2.0 is *very* good, especially if it's still declining or stable.

jeff Marchi | @jeffmarc | 2 days ago

Did your husband have radiation at one time?

Undetectable is considered < .1 though the ultra sensitive tests, go below that and could show < .01. Below .1 would be good enough.

I would imagine he set up for six sessions of chemo (Some people have gone as far as eight) . It could improve even more if he goes all the way to Six sessions. It sure appears that his PSA is dropping over time With each session.

It sounds like he has too many metastasis to zap with SBRT Radiation. Some doctors, will zap over five with multiple sessions.

The side effects from Firmagon are pretty much identical to the side effects from Lupron except you don’t have the pains in the stomach from having taken Firmagon every month. I was on Lupron for 7 years and Orgovyx for 2 years, exactly same side effects. Does he really enjoy what Firmagon does to his stomach every month? If nothing else get him to start on Orgovyx, Again, it will have the same side effects, except it won’t cause the stomach pains. I never had any pain from the Lupron shots (6 month shots), Unless I pressed right, where they put it in on my hip the first day I got it.

brianjarvis | @brianjarvis | 2 days ago

I have no experience or familiarity with all that your husband is going through.

However……, there is a virtual prostate cancer support group meeting on Wednesday evenings at 8:00 (ET) at this Zoom link: https://us02web.zoom.us/j/82817487939

There are a couple of guys who regularly attend that virtual meeting who have personally experienced what your husband is going through.

That would be a great opportunity to ask questions and get experienced responses from guys who have been there.