Zytiga and PSA levels

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smurfine78
Regular Member


Date Joined Nov 2012
Total Posts : 69
   Posted 11/3/2012 12:40 PM (GMT -6)   
My father has advanced prostate cancer with metastases to the bones. He was diagnosed in 2005. Initially, his psa was 2000 but after he started hormone therapy it decreased to <5 and remained there until 2010 when it slowly started rising again.
He has been throught 2 rounds of chemo (one round in 2005 when he was diagnosed, and one round in 2011/2012). His psa has increased again, and a couple weeks ago it was 280. Then he started Zytiga, and after 9 days the psa was 260. After 14 days again, the PSA is still 260. I'm worried about that. Does it mean that the treatment has failed, or can the PSA still decrease?

I also wonder: If a person has advanced prostate cancer and the PSA decreases from 400 to 200 and remains stable on 200, or from 200 to 1 and remains stable on 1, what's really the difference between those 2 situations?
Does the PSA say anything about tumor shrinkage as well?

Raddad
Veteran Member


Date Joined Jul 2011
Total Posts : 1857
   Posted 11/3/2012 12:55 PM (GMT -6)   
smurfine78

Welcome to our corner of the world, sorry you have found the need to be here - but this is where you and your Dad need to be.

9 Days and even 14 days is not that long. Give the Zytiga some time to work. In short - yes the PSA can go down.

I'm been on Zytiga for 7 months now, my Doctor checks my PSA every 30 days.

Hugs

Bud

We will beat this crap
65 - April 2013
A Better Man tinyurl.com/28e8qcg
12 7 11 - 1447 (It's just a number! )
Scans showed active prostate cancer widespread in bones
HT treatments & Zometa for bone
31 10 11 - 46.6 Cheers!
25 1 12 - 75 - Crap
22 2 - 99
22 3 - 149 - Start Zytiga
25 4 - 113 | 22 5 - 66 | 19 6 - 38 | 19 7 -34
21 8 - 27.4 | 21 9 - 36.8 | 6 10 - 33 Down! Cheer

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4450
   Posted 11/3/2012 2:55 PM (GMT -6)   
Welcome to HW, thanks for joining us and sharing your story with us. There will be others along with more experience with advanced cases, so I'll just say welcome...
James C, 65, A Better Man /Injections? Read This
One asks, Several answer, Many learn
4/07: 7.6, 3of16, 5% GS6
9/07: ORP, pT2c, 110 gms., Prob. micro.inv.-left apical mar. G6
5 Yrs: .04 'til 4/10-.06, 12/10-.09, 5/11-.08, 9/11-.14, 2/12-.10, 7/12-.13
Holding, waiting..

smurfine78
Regular Member


Date Joined Nov 2012
Total Posts : 69
   Posted 11/4/2012 1:32 PM (GMT -6)   
Thanks :)

But if the PSA doesn't decrease, does it necessarily mean that the treatment has failed? Or can the treatment still work, even though the PSA doesn't decrease?

Raddad
Veteran Member


Date Joined Jul 2011
Total Posts : 1857
   Posted 11/4/2012 2:09 PM (GMT -6)   
smurfine78

I've found this - but have yet to discuss with my Doctor.

advancedprostatecancer.net/?p=3247

Zytiga – When Should We Discontinue Using It?

have had a number of recent conversations with men with advanced prostate cancer who have been taking Abiraterone Acetate (Zytiga). The question that comes up in regular conversation is about knowing when Zytiga has stopped working or when Zytiga should be discontinued.

All the real guidance we have to answer this question comes from the clinical trials for Zytiga. These trials were all conducted in men with advanced prostate cancer who were both castrate resistant and had failed chemotherapy with Taxotere. In the trials Zytiga was not discontinued solely because the man’s PSA was increasing. Instead, Zytiga was considered to no longer be effective when three things happened:

1- They had a 25% increase in their PSA over the baseline which was taken at the beginning of the treatment.
2- They had radiographic evidence of disease progression as seen in a bone scan, MRI or CAT scan.
3- They had symptomatic progression as defined by the treating physician.

Zytiga was only discontinued when all three of the criteria were experienced, not because of any one of the items.

For men who have elected to use Zytiga prior to their use of chemotherapy (an increasingly common “off label” occurrence) there is no real road map to make this decision. A discussion with your doctor prior to starting Zytiga about when to discontinue should be made as you begin taking the drug. Certainly, the three criteria for the “on-label” use should be factored and given serious consideration when making this decision.

I'm in the off label category as I've yet to have chemo (my plan is to avoid chemo if at all possible)

Hugs

Bud

We will beat this crap
65 - April 2013
A Better Man tinyurl.com/28e8qcg
12 7 11 - 1447 (It's just a number! )
Scans showed active prostate cancer widespread in bones
HT treatments & Zometa for bone
31 10 11 - 46.6 Cheers!
25 1 12 - 75 - Crap
22 2 - 99
22 3 - 149 - Start Zytiga
25 4 - 113 | 22 5 - 66 | 19 6 - 38 | 19 7 -34
21 8 - 27.4 | 21 9 - 36.8 | 6 10 - 33 Down! Cheer
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