Cabazitaxel, Abiraterone or Enzalutamide?

[andysb]

Hi, I am a newbie on here from the uk,

I got diagnosed with PC in June 2014, my PSA was 131 so I had a MRI, CT and bone scan.

The cancer had spread outside of the prostate and onto my spine, right hip and on one of my lungs, I was put on a Prostap injection every 12 weeks. My PSA came down to 27.

In April 2016 I had an accident and bashed my head, I was taken to hospital and had to have an upper body and head CT scan, everything was ok until I went for a 6 monthly appointment a week later with the oncologist, he told me that my PSA had risen to 95 and he also said that the X-ray department had sent him the CT scan, I was told that the cancer had spread on my spine and also some of my lymph nodes had become enflamed.

I had to have Docetaxel chemotherapy every 3 weeks, 10 sessions in all, my PSA steadily came down to 22 and all was good!

3 months later my PSA was steady but then it started to rise again and in September 2017 it had gone up to 121.

I had another CT scan and it has spread quite aggressively on my spine and now I also have some on my ribs!

I have been given 3 options which are Cabazitaxel, Abiraterone or Enzalutamide!

I don't really want the Cabazitaxel chemotherapy this close to xmas because I think the side affects off it will make me unwell, other than slight side affects I had off the Docetaxel all I get now is a bit of tiredness and back pain which comes and goes.

I have decided to go with the Abiraterone!

What are your thoughts?

I feel really good in myself and want it to stay that way for as long as possible!

Thanks Andy

[andysb]

Meant to say, I am 57

[Dan59]

Andy, Welcome to the group. I would have made the same choice to do abiraterone and try for a response ,It was very tolerable for me. I got about a year out of it, then I did xtandi and got over 2 years. As My Oncologist said

“You can do Cabazitaxel at any time”

I did 5mg prednisone with abiraterone.

I wish you the best

[RonL]

I’m currently on Abiraterone (Zytiga), adding it to my treatment didn’t cause any additional side effects. Good luck.

[andysb]

Thank you so much, I hope it works for me!

[Hidden]

I think you made the correct choice, good luck.

[Hidden]

I'd second or third on the Zytiga. I agree with Dan regarding the chemo. You can do that later and I believe it's best to wait around 6 months or more before re-challenging chemo. My doctor told me it's best to re-challenge with Docetaxel first, then move to Cabazitaxel if there is poor response. Good luck with treatments and let us know what you do.

[ctarleton]

Welcome. I'm glad you were given a range of multiple options to consider. Go boldly into Life in the months ahead now that you have made your decision.

Talking and sharing with others in a face-to-face Prostate Cancer Support Group can be quite helpful during the course of treatments. Here is a link to search for Prostate Cancer Support Groups near you in the UK:

prostatecanceruk.org/get-su...

Charles

[andysb]

Thank you all for the advice, I was given the three options to consider and then spoke to my oncologist about them on my last appointment. He said to me that there is no order for the three treatments and it’s entirely up to me.

Because I feel so well I did mention to him about not having any treatment at all, he told me that I was too young and advised me to have one of the treatments, I said to him that I think I prefer the Abiraterone and I will be having it on my next appointment.

My next appointment is 21st November, I will keep you posted of how it goes!

Thanks Andy

[Hidden]

Other drugs to consider, especially if you have metabolic syndrome (high blood pressure, overweight, insulin resistance (high glucose?) (even elevated a1c)), are metformin, asprin, statins. Do you have BRCA2 mutatation (based on your young age)? if so, check out PARP inhibitors, and, by all means, check out any clinical trials at the Royal Marsden.

There is a good deal of enthusiasm among patients for aromatase inhibitors (in order to prevent testosterone from being modified to DHT). Less enthusiasm among the practioners however.

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

etc...

[andysb in reply to Hidden]

I have never heard of BRCA2 or PARP, I already suffer from high blood pressure, it fluctuates daily but am being treated for it.

I still go to work at the moment so I can’t really go on clinical trials as it might affect my working life.

Thanks Andy

[YostConner]

I got 32 months of benefit out of Abiraterone. Good luck!

[chuckotheclown]

Hey Andy, I am currently on "Abi" with Lupron. Lupron started in January and Zytiga in August. The combo have been most effective and no noticeable increase in the side effects of Lupron. I exercise 5-6 days a week and eat a plant based diet to fight fatigue and good elimination. It's working.

[celler6]

Zytiga is a great call. I have had all three; this is the best.

[whatsinaname in reply to celler6]

For you, it worked. For me, it did shit all

[andysb]

Hi all, Four weeks ago my PSA had gone up to 192, a lot higher than expected, I have been on Zytiga for 15 days and now it has already dropped to 108, I hope it keeps going down at that rate!

The side effects I am getting is my hands feeling a bit shaky at times and feeling weakness in my arms, the worst thing though is the diarrhoea! It’s really bad, got prescribed some Imodium and it only helps a bit.

Does anyone else suffer from this?

Thanks Andy