Advanced Prostate Cancer
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PSA incr-should continue Zytiga ?&bone mets incr but ok CT //OTC pills now-- what dr. manages pain progression?

Should DH use Zytiga now? Always had low psa but increasing after IADT.

2/16- .67 –restart Lupron


4/23 .24





9/16/161.08—start ZYTIGA 10/14-.79 11/16- .65--ZOMETA,SICK


PSA 12/16/16-1.01~1/04/17-1.46 -

1/11/17- 1.57

12/25/16 rib/back pain started

1/04/17. MO appt.-more bone mets, ct scan ok,

1/08 cont.Zytiga(BUT increased PSA), cont. Xgeva and Lupron,

RO appt 1/11 to start Xofigo if qualify

More info is in the signature. ...good health, 82 years XCPT G9 cancer. Thx for your advice. Annie

10 Replies

Sorry, I don't understand your post or the numbers. Can you better explain?



Zytiga did not work for my husband - starting chemo again Cabazitaxel to stop the spread of prostate cancer in his lymph nodes - we pray it works


OK, I'll bite. Again!

Hi Annie,

Can you please send us the enigma decipher code, please?

Peace, Joe


Greetings - as the others stated, not clear on the stats but I have increasing PSA after 3 1/2 months on Zytiga. Even with latest PSA at the highest yet(60), I have no pain but I worry bone mets could be spreading and pain will arrive any day. I had CT & bone scan yesterday so we'll see.

radium 223 or Jevtana chemo may be next options.



Hello jrow,

Thx for your response. My husband, Dave, has always had really low PSA since diagnosis. So MO says PSA doesn't help which is frustrating. (The stats above won't show PSA date and then SPACES!!! before PSA number .)

Zytiga did not work for Dave shown from his PSA results and the bone mets are greater in last 6 months.

What results do you have from your recent CT and bone scan? Best wishes for a favorable review.

Dave chose radium 223 (xofigo) and will start next Thursday . Mo prefers Xofigo first before chemo. But MO's opinion is influenced because MO generally resists chemo, especially since Dave is 82 (in good health except for this wretched cancer!)

Take care, Annie


Thanks Annie. My scans this past week showed bone met progression ( with some limited pains at this time) and my oncologist recommended radium 223 which I plan to begin next week. As long as it's in bones only radium (xofigo) is recommended. If needed later, I will likely need another round of chemo using Jevtana.

So Zytiga didn't work and that was used after chemo last year - I remain on Lupron & Xgeva quarterly but I am clearly hormone resistant.

I am getting another opinion at John Hopkins Tuesday. Current treatment is managed by University of PA's cancer center.

By best to you and dad


My read is that his psa rose from 0.67 in Jan 2016 and has now increased to 1.57 in Jan 2017. I presume that Lupron was continued. Zytiga was used, at least part of the time. Zometa and then Xgeva, both bisphosphonates (right, guys?) were used at times. BUT BOTTOM LINE IS PSA HAS ONLY SLIGHTLY MORE THAN DOUBLED IN 12 MONTHS. That would normally be considered as good, but he does say he has always had a low psa. Have docs looked for neuroendocrine (small cell) cancer which I understand may not produce hi psa's ?



Sorry for my confusing info. YES, Herb, you are correct in your message above. DH (Evan) has always had low PSA. Shows date and then PSA( now spaced for better reading!)

DATE PSA action

2/16/16 .67 restart Lupron

3/23/16 .31

4/23/16 .24

5/17/16 .21

6/15/16 .32

7/13/16 .44

8/16/16 .81

9/16/16 1.08 start ZYTIGA &prednisone

10/14- .79 completed 18 spot radiation

11/16- .65-- start ZOMETA,(sick reaction)

12/16/16- 1.01~ start XGEVA (no side effects)

1/04/17- 1.46 -

1/11/17- 1.57


12/25/16 rib/back pain started


UPDATE Thursday, 1/12/17. Just finished 2 weeks of tests and RO and MO apps.

Results from: 2 bone scans, 2 1.5T MRIs, 2 CTA s, 4 blood tests,

Bone mets have increased (ribs, spine, pelvis ) since 9/2016. No visible soft tissue mets.

Tylonal or Advil controls discomfort in bones affected.

Zytiga has not helped.--so stop Zytiga

Continue Lupron and Xgeva.

Start Radium 223 (Xofigo) on Jan 18.

Thanks for all of your responses.



Oh no! I had spacing between PSA date and PSA result but when posted that info is again mushed together.

Joe, you asked "Can you please send us the enigma decipher code, please?" All I can say is I'm still learning how to format on the website. Thanks for your patience! Annie

1 like

Hi Annie. Hope the Radium is successful for your husband.


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