I wanted to share my dad's latest results after completing Provenge at the end of July. I have written before on this forum - was very concerned about
his back pain and rising PSA after Provenge. He had a complete set of scans and bloodwork done about
three weeks ago at MD Anderson. The scans showed no new signs of progression and the tumor markers in his blood were down from 107 to 6. His doctor at MD Anderson was very encouraged by this. He was prescribed Zytiga in mid August. It initially brought the PSA down from 60 to 20. Now, it is steadily climbing and has gone from 30 to 37 to 49. However, he is not in any back pain - is doing much better and may take an occasional Tylenol vs. hydrocodone which had been prescribed to him before. He feels great despite the PSA spike. Both his doctor at MD Anderson and Northwestern have said they see PSA spikes like this with people on Zytiga. It could be no longer working, but the odd thing is he feels better than he has. This sounds a bit like Packard's experience in that his PSA is now rising...
My dad's doctors are possibly recommending chemo once every three weeks and Xofigo as next steps but not recommending doing anything yet. They are not alarmed by the current PSA rise -said they would be looking for much larger spikes.
I am somewhat relieved but also very concerned at the same time. I don't know much or haven't read much on this forum about tumor markers in the blood that are tested... I thought PSA was considered one of them based on my internet research but I guess there are others. How can it be that tumor markers are notably down in the blood but PSA is rising? I think my dad's condition is evidence that Provenge has definitely helped to keep the condition in check, Zytiga has helped or is helping, but PSA is rising. Just seems like chasing the PSA number is an ever elusive thing - my dad's doctors said they put more emphasis on the scans and how the patient is feeling as to what is going on with the cancer vs. the PSA.
Anyone out there have any insight they've gleaned on this type of situation, condition, etc.? Wonder if there is any other advice he should be seeking... possible other medications, etc.