That is an unusual presentation., Unfortunately, some of the most virulent types of prostate cancer put out low amounts of PSA. Did the pathology report offer any clues about
what type it is?
Where are you located? In the US? There is a large US NIH-funded trial called "NCI Match" where one can submit tumor biopsy samples and they will do a genetic analysis of it in the hope of finding rare types that might respond to available medicines. Currently the only such medicine I'm aware of for PC is a PARP inhibitor. But since it doesn't cost anything, and you already have the biopsy tissue, you have nothing to lose. The following link has a list of trial sites all over the US where they can receive tissue samples:/www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=773118
Another thing worth considering is participation in clinical trials. I suspect that the combination of chemo and immunotherapy will be very effective and complementary. The only immunotherapy currently approved is Provenge, but it is only approved for men with rising PSA after hormone therapy. You can try to get insurance approval based on the current spike in PSA perhaps? Otherwise there are clinical trials of ProstVac or Keytruda that he might qualify for. It may be worth discussing with his oncologist.
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Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEsmy PC blog