Zytiga while hormone sensitive

[Blair77]

We met with Dr. Schulz in L.A. He's given us the green light to start Zytiga while still hormone sensitive. So my husband is taking casodex, Lupron, zytiga and about to finish his last cycle of Docetaxel. 🤞

[Sisira]

You are virtually using all the strong bullets in a modern multi-prong attack, taking the earliest available opportunity. Right way at the right time!

Best of the benefits to your husband's well being.

Sisira

[Dr_WHO]

Good luck! I am a firm believer in hitting cancer with everything you can! If possible could you share your husband's stats (Gleason, PSA, scans, etc)?

Please let us know how the treatments go.

[Blair77 in reply to Dr_WHO]

Gleason 4+5, PSA 1044

I will look for scan information

[Dr_WHO in reply to Blair77]

Thank you. With those numbers you definitely should hit it with everything you can. Good luck!

[Spitzz in reply to Dr_WHO]

I AGREE - hit it fast and hard....

[David20451]

I too believe in this approach. Hit it hard. Good luck!

[j-o-h-n]

Yep..... treat it like a new wife...(just joking, just joking, cause my wife just came into the room)

j-o-h-n Saturday 08/05/2017 10:14 AM EST

[Hidden]

Good move, I may be right behind you.

Kick the cancer hard, knock it down and then stamp it while it's down. The harder you stamp on it now, the longer it will take to get back on its feet.

I'm doing my last cycle of Docetaxel on Monday. Plan on making a decision in late August. regarding going on Zytiga. The problem for me is that both my Medical Oncologists are against it. That's making the decision harder for me.

[Blair77 in reply to Hidden]

Do they say why they are against it?

[Hidden in reply to Blair77]

One of my doctors said if I use it now I won't have for later which to me is not a good reason. That's old thinking. She was a big advocate for using chemo early and not saving that for later so it doesn't make sense. Using Zytiga early gives you more time, that's more important than having something later that gives you less time.

The other doctor seems to think that if you do early chemo, you shouldn't do early Zytiga. He prefers Xtandi over Zytiga and feels that doing Zytiga now will make it likely that Xtandi won't work later because of cross-resistance between the two.

In his defense, as far as I know, they haven't proven that those who do early chemo will get an additional benefit from also doing early Zytiga. I can see his point. The trials that have been done so far have been either early chemo or early Zytiga, but not both. So maybe for those who have done early chemo, early Zytiga doesn't add as much or maybe doesn't add at all. That's the only question I have right now.

[pjoshea13 in reply to Hidden]

Gregg,

My RP failed 13 years ago, but I still act as though I would have another 13 years, if I didn't have PCa. So any monotherapy that is likely to fail within 2 years is not at all attractive. With short mean-times-to-failure, single threading becomes mathematically absurd.

There have been studies on Zytiga before/after Xtandi, & while they are interesting, if one builds resistance to the other, why not use them together? I think that Xtandi can be rough on one, & I would opt for (Lupron +) Zytiga with Casodex instead.

Plus a lipophilic statin & Metformin & Avodart ...

Who knows how long the combo might be good for?

Best, -Patrick

[gusgold in reply to pjoshea13]

Patrick,

what are your thoughts on chemo? Do you buy the theory that chemo damages the immune system which prevents supplement protocols from being effective. One onco told me the right supplement protocol can be just as effective as chemo.

Gus

[pjoshea13 in reply to gusgold]

Gus,

Did he mention what "the right supplement protocol" was? LOL.

The immune system is permanently damaged by Taxotere? I only know about neuropathy that may not resolve.

There is a 2015 study [1] that showed that low-dose prednisolone:

"reduced the incidence of peripheral edema, grade 3 nonhematological toxicity, and the risk of being admitted owing to febrile neutropenia during treatment with" docetaxel.

Implying that dampening the immune response was beneficial, but that Taxotere didn't do that.

I'm not sure that any of the supplements I use depend on the immune system.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/262...

[gusgold in reply to pjoshea13]

Patrick,

I am thinking more in terms of secondary cancer prevention

Gus

[Dr_WHO in reply to Hidden]

The hole point of the Stampede and Latitude trials were to answer the question do you live longer taking one hormonal therapy then another when the first fails vs hitting the cancer with both at the same time. The answer was dramatic. Better life expectancies and time before PSA breakout occurs when both hormonal therapies are used at the same time. It is true that you lose the ability to use Zytiga (or other drug) if/when PSA rises but you actually gain more time.

Here are some references

nejm.org/doi/full/10.1056/N...

ascopost.com/News/55700

[Blair77]

We are also going to do a Statin and Metformin as an add in. Plus treating the primary ( prostate) with Radiation. It's big guns all the way....

[DaughterOnAMission]

How have things been? Was your plan successful? This is exactly what I'm going to ask Kaiser to do for my dad..... I'm very curious!

I copied what you did here: "Zytiga while still hormone sensitive. So my husband is taking casodex, Lupron, zytiga and about to finish his last cycle of Docetaxel. Statin and Metformin as an add in. Plus treating the primary ( prostate) with Radiation. It's big guns all the way..."

[Blair77]

I’m sad to say that at his last round of chemo he developed an infection and went into septic shock. He spent days in the ICU and I wasn’t sure he was going to survive. I got scared off of the “big guns. His PSA dropped from 1044 to 1.6 as of a few weeks ago. He’s on metformin, Lupron and casodex. But I was scared for him to start the Zytiga because his local oncologist didn’t agree with Dr. Scholz on its benefit upfront. We might look into radiation to the prostate this summer. How old is your dad?