First week of April started experiencing pain in left femur area, thoracic spine and ribs, and front chest.. Initially controlled with Naproxen Sodium. Pain in femur has pretty much resolved. Pain in Thoracic spine, ribs, and chest has gotten much worse, now severe and continuous, requiring hydromorphone (2 mg every 3 hours) last week or so. Coughing causing pain in chest, ribs and thoracic spine.
Blood tests generally within normal range, PSA 1.14, Testosterone 17. CT Scan and Whole body bone scan: Metastases in the sternum and thoracic spine have increased in size and number. Mild anterior wedge compression at T7 which may be metastatic. T 11 and 10th ribs are involved. Impression metastatic disease in left femur has improved, worsening metastatic disease in the thoracic spine and adjacent ribs. Referred to a radiation oncologist for Xofigo consultation. Expect to start Xofigo in a couple of weeks. Medical oncologist suggests starting Xgeva again. Currently still on Eligard injections every 6 months. Thinking I will start Xgeva again in view of first evidence of vertebral compression, despite all past bone density studies being normal and additional risks and side effects of Xgeva. Probably while doing Xofigo. Thoughts?
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