PSA up again

sophia · Posted: Wed Jul 30, 2008 12:53 pm Post subject: PSA up again

My Dad was diagnosed with prostate cancer (4+5 Gleason score) and a PSA of 1256, with bone and lymph metastasis on mid of April. He has been on hormone therapy (Flucinom) and on a three month injection (Zoladex), as well as a Zometa injection for his bones every month. He has only had one Zoladex injection and a month ago while checking his iron, calcium levels and stuff like that his PSA had gone down to 56.
His doctor was not as happy as we were, told us to wait until three months have passed.
Today he had a PSA test which revealed the shocking 456. It has risen again. Doctor said he might need to change the treatment. Or start chemo. We will check the PSA level again on September.
I am so very depressed. He, at first responded so well to the treatment. I had hoped it would last longer. Now i know there is not much we can do.
I have read through numerous sites on the internet, it all comes down to a dead end now.
I am so very worried and desperate.
Anyone out there who knows something more than i do?
Is it possible that the PSA value drops again?
What about the new treatment option? The one that is supposed to be a great step towards the cure of PC? Is it out there somewhere? Can I get it here in Greece?
Sophia.
_________________
"I have been guilty of kicking myself in the teeth...
I will speak no more of my feelings within.."

Replicant · Moderator Joined: 01 Nov 2006 Posts: 244

Hopefully your father is the hands of a medical oncologist who specializes in prostate cancer. The oncologist can try some different ADT strategies (stopping one drug, adding a different one) to see if that helps, and then there is chemotherapy, which could be combined with ADT or employed by itself.

The trial you're talking about is a large international phase III trial for Abiraterone Acetate. Outside the United States, the locations are limited to the UK and Australia.

To qualify, patients need to have tried and failed one or two chemotherapy regimes, and one of those regimes MUST have been docetaxel (Taxotere). So it would appear your father has to go a bit further down the treatment path before he would qualify for the trial. Also, this is a randomized trial and some patients will not receive abiraterone, but a placebo. All patients will receive prednisone, however.

There are trials that your father might qualify for BEFORE the abiraterone--involving various chemo combinations, immune based therapies, etc. For more info see the international trials portal here: http://www.ifpma.org/

Here are the locations outside the U.S. for the abiraterone trial:

United Kingdom
Royal Marsden Hospital
Sutton, United Kingdom
Contact: JS de Bono, MD
0207 808 2383

Australia
Ashford Cancer Centre
Ashford, Australia, 5035
Contact: Francis Parnis, MD
618-351-0211
adelaide.cancer.centre@bigpond.com

Southern Medical Day Care Center
Wollongong, Australia, 2500
Contact: Glasgow, MD
+61 2 4228 6200

Royal Adelaide
Adelaide, Australia, 5000
Contact: Michael Brown, MD
+61 8 8222 4398
Michael.Brown@health.sa.gov.au

The Mount Hospital
Perth, Australia, 6000
Contact: Dr. Van Hazel, MD
+61 8 9481 8373
guy@perthoncology.com.au

Royal Hobart Hospital
Hobart, Australia, 7000
Contact: Louise Nott, MD
swigston@bigpond.net.au

http://www.royalmarsden.nhs.uk/RMH/cancer/learnaboutcancer/prostate/abiraterone.htm

http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.4343613/k.52FC/Abiraterone_Acetate_Trial.htm

Best of luck--thinking of you and your father, Sophia.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com

sophia · Posted: Fri Aug 08, 2008 2:05 am Post subject: Re: PSA up again

Thanks for the contact information, Replicant. I am most grateful as it seems that if it werent for you, it would be difficult to find it.

You were spot on. The bad news is that abiraterone acetate is not given to all recruits. They want to rule out the placebo effect and so one third of the patients must take the placebo pill. (I am not willing to put my father through such a procedure, even if i could.) Plus all recruited patients must have had one or two regimes of docetaxel chemotherapy and failed, and my father has not had any chemo yet.

The plan for now is to go on holidays for about a month,have a great great time with him, return and meet with a good oncologist who knows what he is doing.
His urologist said that while his first reading was 56 and his second, after a month, 456, it does not make sense. One of the two must be wrong. So there is a slight chance all is going well and the second reading is just another stupid medical mistake. But what are the chances?

I bought aloe for him to drink every day. It is suppposed to be a miracle herb according to Hippocrate, even shrinking cancer tumors.

Does anyone out there know how long chemotherapy works for patients like my father?
_________________
"I have been guilty of kicking myself in the teeth...
I will speak no more of my feelings within.."

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