Zytiga and nausea

[Cancersucks]

Ex is having bad issues with nausea/vomiting and last week decreased his dose of Zytiga from 4 to 3 pills/day, which has helped a little. Onc doesn't feel the need for another PET scan (last one was 1/16) because results wouldn't change treatment plan. Anyone else having problems with nausea while taking Zytiga/prednisone?

[wrando]

Not yet...I've been on it for about 4 1/2 months

[Hidden]

I'm two weeks on Zytiga with no side effects whatsoever.

Joe

[charmander]

i've been on zytiga & prednisone for 15 months with no nausea. My only side affect is kind of foggy brain, forgetful and sometimes unfocused. He is taking on empty stomach? Pet scans are not normally done on a frequent (less than yearly) basis unless there is a change in numbers. Your ex has bone lesions? Has onc talked about xtandi to replace zytiga?

[JoelT]

If a scan showed a significant amount of disease progression then perhaps it wold change the treatment protocol.

Joel

[CERICWIN]

I've been having major nausea issues and I'm on Xtandi. My doctors first prescribed Ondansetron for nausea---a little white pill which is dissolved on the tongue and acts very quickly.

But it hasn't been enough lately, I've had increased nausea, so my doctor prescribed a patch, a Scopolamine patch---a tiny round transdermal patch that is placed behind the ear, and lasts for three days.

Both of these drugs are prescribed for chemo patients. You can ask your own doctor about them.

CERICWIN

[Cancersucks]

Hi Eric,

He has those meds plus compazine and phenergan. Xtandi never gave him nausea but he had a really hard time with it, mostly emotional. I'm worried about the nausea because he has had disease progression through all treatments and has hundreds of bone mets....lab work okay, PSA is 96, pain manageable now with only a 20mg oxycodone in the morning. Just would like to know if N/V is related to meds or cancer progression...

[Hidden in reply to Cancersucks]

Cancersucks - you might consider stopping the Zytiga since it is rarely effective after failing Xtandi. Then you can see if the nausea stops. If not, it could be the illness or some other medication that is being used.

[Spitzz]

On Zytiga / Prednisone for 10 months - never had Nausea or Vomiting and overall my body did well. The only issue I had was my blood pressure started to rise after about 5 month, could very well be the PREDNISONE as mentioned in the side affects. Changed my BP meds and we're off and running

GOOD LICK

[PaulC2]

I've been taking Zytiga+prednisone for years with no GI problems. Maverick that I am, I ignore the instructions on the label (which were designed to make standardization and marketing easier, not for patient well-being), and take it with food. This potentiates its effects and also makes it easier for me to take.

[Spitzz in reply to PaulC2]

Question, are you taking the full dose (4 pills)? When you say "YEARS" can you put a numeric value to it? I've taking it for 11 months and the only side affect I had was my blood pressure increased, resolved with Hydrochlorothiazide..

[PaulC2 in reply to Spitzz]

Yes, I take the full dose of 1000 mg = 4x250mg pills.

I've been on Zytiga for three and half years, since January 2013.

And yes, I've had some side issues because of ADT (androgen suppression):

• After Lupron ruined my bone density, I took alendronate(Fosamax) for a while and have since "graduated" to denosumab(Prolia).

• Despite a low-sodium diet and gym workouts 3x/week, my blood pressure, like yours, and reached a point where I started taking medication, but nothing major.

• Despite a sugar-free low-carb diet, my glucose has been slowly climbing and is reasonably well-controlled so far on metformin(Glucophage).

[Neal-Snyder]

That's interesting--potentiates? I've taken it for over 2 years, as directed, without side effects, other than easy bruising from prednisone.

[PaulC2 in reply to Neal-Snyder]

Here's my understanding of why the label says not to take with food. In clinical trials, it was found that taking it with food had a strong effect on the absorption and serum level, multiplying the effect by as much as 8x in some men and 2x in others, with no obvious pattern explaining the wide variation.

Rather than doing further research, the manufacturer just specified a standard dose of 1000mg/day on an empty stomach, resulting in a standardized amount of drug in the bloodstream.

Well, I've always been a tinkerer, and I seem to have a somewhat-higher-than-normal threshold and much higher-than-normal tolerance for many kinds of molecules.

I asked my oncologist about the drawbacks of taking a much higher than usual dose of Zytiga. He was unaware of any beyond blood pressure and possibly metabolic syndrome. In the past, he's known me to be a responsible guinea pig with myself, and so (with a bit of reluctance, and much cautionary warning) didn't-forbid my experimenting with a higher dose

So I embarked upon a three-month trial period of tapering up the Zytiga by taking it with meals, two pills in the morning and another two at night (smoothing out the response) to see if anything went seriously out of whack. Nothing did, and I've been on Zytiga monotherapy ever since. (Well, almost monotherapy; I take dutasteride(Avodart) as well. )

[Neal-Snyder in reply to PaulC2]

Thank you, Paul. Did Zytiga with food help you more with your PSA that Zytiga without food?

[PaulC2 in reply to Neal-Snyder]

Theoretically, it should.

But I've not been enough of a guinea pig to put it into practice — following the label instructions is sufficient to drive my PSA down to the 0.08 level, and my current 0.06 is, I suspect, no more than background noise rather than indicative of any hypersupersuppressant effect.

[Cancersucks]

Thank you all for the replies. We just got the depressing, although not too surprising, news that PSA doubled from 92 to 186 within two weeks. Ex has been taking Zytiga for 10 weeks. Docetaxel early after diagnosis last year did not lower PSA at all and he is saying no to any more chemo. Pain is getting worse. We are quite discouraged...

[Charlean]

I am so sorry to hear that things are not going well. My husband had similar issues with the drugs and his cancer. IT seemed that once things stopped working, it didn't matter what we did. It was a steady climb and increase in mets and so forth. What we found was that opiates don't help all that much with the pain and so we relied on cannabis oil, which helped a great deal, but it sounds like the new drugs aren't going to do much and of course the side effects also sound like they are taking away quality of life. Once we stopped all that stuff and just focused on pain control, Harley felt much better but the cancer doesn't stop. Keep an eye on the mets in his spine. SCC was the beginning of the end for my husband.

Charlean

[Cancersucks in reply to Charlean]

Thanks, Charlean. He is at high risk for SCC as cancer had caused compression fx from L1-L4, yet he still rides bikes with our little ones and holds our 45 lb daughter in his arms. Opiates sometimes helps the pain and he does use cannibis oil as well. Xgeva helps for a couple of days and the prednisone also helps. I watch him get about 8 hot flashes an hour and the change in his body visually is hard for him.

[Salliexo in reply to Charlean]

Hi Charlean, I know that you haven't posted in a while, but if you are still active at all on here I was interested in talking to you. My father has S4 Metastatic prostate cancer, and only realized it had spread last year (July 2016) when he went into the hospital and became paralyzed from the waist down due to SCC. He was on Xtandi and then Zytiga, combined with radiation, but found out this week that it has still spread so he is now in at home hospice care. He's used cannabis oil in light doses but we are looking to put him on a more intense regimen, since he is stopping all of the cancer drugs. I was interested to hear more about your husbands response to the cannabis oil after stopping the intense medication.

Thanks so much <3

[Charlean in reply to Salliexo]

Your post came to my email so I will respond happily. You can privately email me at [e-mail] I am very sorry to hear that your father has to deal with the same problems. Sadly, this is all too common and yet we were never warned of it. I would be only too happy to share what we went through and how cannabis oil helped him.

Charlean

[Charlean]

I hope he can enjoy his rides for a very long time. We did the Lupron until the end and of course I often wondered what difference it really made when they said he was castrate resistant because as you say, the hot flashes, the weakness, just made him feel so useless around here. Glad to hear the Xgeva is helping with the pain as it just made Harley feel so sick and miserable that he couldn't continue it. My prayers are with you both.

[Sergio1]

the same problem

With three pills do you have the same benefits?

[Sergio1]

Thanks for the reply. My oncologist is against three pills. He says the procedure involves 4 pills. I would like to know if others have nausea problems