Connect
Rut Roh Rorge - PSA wrong direction
ADT / ARSI since June 2025
IMRT Oct 2025
PSA:
4/21/25 - 30.11
7/9/25 - 0.55
8/26/25 - 0.19
12/3/25 - 0.23
3/17/26 - 8.80
Methinks there's a problem. 😮😮😮
Results just popped up on the portal. Haven't heard from the Doc yet but I'm guessing another PSMA PET is in my near future. ALP is pretty high too, so liver or bone mets? Not yellow yet so I'm guessing bone. Maybe an ALP Isoenzyme test to determine source of elevation?
In any case, this sucks a little. 😡
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
You are right, a PSMA PET scan is really what is needed right now. Since this came on so quick, they will probably find metastasis that they can zap with SBRT radiation and your PSA will go down again.
Being on both drugs at this time means that you have probably now become castrate resistant. Happened to me six years ago while just on ADT. At that time, ARPI drugs worked for me.
Depending on what they find with the pet scan they may want to do Pluvicto or Chemo, But that would be unusual for such a short term rise in PSA. More likely, they will find something to zap.
Wish you the best. I know my combo of ADT and ARPI will not last forever, so many of us are just waiting our time. I have heard of some positive clinical trials going on right now for people in this situation.
-
Like -
Helpful -
Hug
2 Reactions@jeffmarc
I don't see Pluvicto in my future due to a TP53 mut, but I believe Docetaxel will probably be on the menu. Hope you're right and they can find something to zap so I can stay off chemo as long as possible. I clearly remember what Taxotere did to my wife, pretty ugly.
Looking back on your profile, you did have s metastatic lesion to the spine; however, your IMRT history seems to be just to the bed?
Did they ever treat the spinal lesion with SBRT? Your guess of bone would be correct if that’s the case. Best,
Phil
@heavyphil
Hey ya, phil. No, plan all along was to kill the primary tumor (IMRT to prostate and vicinity) and control distant mets with ADT. Everyone, including myself, was hoping for a longer duration before going castrate resistant. No way all mets were directly treatable, too many, too widespread. Now it looks like it's time for some SBRT whack-a-mole on what they can target and probably chemo for what they can't.
-
Like -
Helpful -
Hug
2 Reactions@jeffmarc
Jeff, isn't that very quick to become CR? I always thought it was a lot longer than less than a year but I'm kinda new to this.
@mjp0512
Best of luck to you sir. Keep us informed!!! Sending prayers and strength...
@dpayton
If you are just on ADT, the median time to castrate resistance is two years. That’s why they recommend an ARPI, it is so important, It will delay CR for a much longer time.
It was 2 1/2 years on ADT before I became castrate resistant.
-
Like -
Helpful -
Hug
2 Reactions@jeffmarc
Leave it to me to be an overachiever and get there in 9 months even with darolutamide.