On to the Next Step

[Baddawg]

2012-Urologist biopsy with Gleason 9; (2012)-Dattoli Cancer Center, Sarasota, FL for Color Dopler affirmative PCA; 8 weeks Conformed Radiation, seeding, follow-up radiation; ADT. (2014) PSA doubling-Sand Lake Imaging Pet,CT/MRI, Ferheim (sp) imaging-no mets found. Continued ADT and supplements+Metformin. Oct 2015 off of Lupron and Casodex, still on supplements. Jan 2016 PSA doubling, back to Sand Lake Imaging-CT/MR AND F-18 Pet Bone Scan-Positive Met indicators of Pelvic and T5 & T8. Scheduled for Zytiga and prednisone, Xrelto and patch, back on casadex, and remain on Metformin, Avodart, flomax....... then???

[Darryl Partner]

I've asked our Advanced Prostate Cancer program director to reply regarding, what might be next for you, but, for now, I want to say, "really nice photo!"

[Baddawg in reply to Darryl]

Thanks , that is very kind of you. Of course u refer to my pretty spouse!!

[JoelT]

Jon, I have to add my comment to Darryl's , nice picture. Thanks for sharing it with us.

Based upon the description you shared it looks to me as though you have been receiving cutting edge treatments and diagnostics.

In answer to your question, what is next, there are a number of possibilities available for you besides the Zytiga. However, I would suggest that you consider looking into Provenge at this point, either before or during the Zytiga. Provenge is most effective if you give it time to work. It is different then the other treatments that we have available to us. The other treatments like Zytiga have an immediate effect on the PSA etc., but for Provenge it takes time to experience a positive effect. So, the earlier you have it the more positive result you might experience.

I also would ask about Xtandi now instead of Zytiga. I believe that it is a superior drug that doesn't require the use of prednisone which comes with its own set of side effects.

However, currently we do have additional drugs besides Zytiga, Provenge and Xtandi. They include docetaxel (chemotherapy), Xofigo (Radium 223) for the treatment of bone mets, Jevtana and mitoxantrone.

Additionally, there are a number of other investigational drugs in clinical trials.

[Baddawg in reply to JoelT]

Thanks, good info and I will bring these up in my notes when I meet with Dr. Dattoli tomorrow and let u know what he has for me next.

[Baddawg in reply to JoelT]

Hi Daryl:

Dattoli meeting and results as best my notes show: Discussed Scans and they showed mets to the following areas-the T5 measured 34 and the T8 measured 28, rib measured 8, and left pelvic measured 13. Treatment Protocol will be: Zytiga 250mg with prednisone. Received double Firmagon shot at the center, then single monthly with every 3 month blood work; will be mapped for radiation and will be given treatments to mets. Will be on Xgeva a couple of years with break in between, Xofigo once a month for 6 months. Continue meds: Avodart, cabergoline, Vit D3, Casadex, Flomax, and Metformin.

I will keep you abreast of the continuing treatment results.

Regards,

Baddawg (comes from my football days at the Univ of Georgia)

[Darryl Partner in reply to Baddawg]

Sounds like a good plan. Keep us updated as you get new results from scans and blood. Good luck!

[Baddawg in reply to Darryl]

will do.

[Baddawg in reply to JoelT]

Jon

See my recent post to Daryl FYI or ask him to forward it to you,

Regards