Hi. Diagnosed with PC in June, 1994, Gleason 6, PSA 85.Went on intermittent hormone therapy - Lupron + Casodex -for about 14 years, which initially brought my PSA down to<0.1, but gradually became less effective.. Then tried Casodex and Avodart combo, which sort of controlled the cancer for nearly 3 years and did restore some of my energy. Back to Lupron, which at this point was moderately effective for 2 years, but the PSA started rising again, rather rapidly to 136. Started Zytiga in January 2014, which did bring the PSA way down to less than 50 after 2 months, but caused an extreme rise in liver enzymes and much tiredness and energy loss. When the liver tests returned to normal after two months, I resumed the Zytiga at a lower dose, but stopped it when the tests began rising again. I only got a little of my energy back, but the PSA continued down to a low of 11, staying there for a few months when it began rising again. I started Xtandi in the fall of 2014, and the PSA went down to 14 for a few months. Have stayed with Xtandi, with the primary side effect being tiredness and low energy, But the PSA has been rising - last reading was 66 - while a recent bone scan showed no change in the mets from the one 4 months previously, which did show an increase in the number of mets from 2 years previously. I may have to switch my treatment before long.
Complicating things is that I had a lower left molar tooth pulled recently, and the oral surgeon noticed some "compromised" tissue in the adjoining bone area. I had been on Xgeva for a year and a half, stopping in August, 2015, and on Fosamax for 7 1/2 years for osteopenia, stopping that about 8 years ago. I have been told that it is very unlikely that I have osteonecrosis of the jaw, but no one can say definitively, or if or when I might resume the Xgeva. And a periodontist wants to do a deep cleaning procedure, which might cause more bone exposure. So much for the art and science of medicine.