I'll try to keep this post short and simple:
I'm trying to decide whether to push for/encourage an oncologist to add zytiga and prednisone to my Lupron. My situation is this: I'm 52 years old, athletic, diagnosed with PCx in May 2015, Gleason 4+3 and 4+4. Failed brachy/IMRT combo in late 2015, PSA doubling rate of 3 weeks during recent intermittent Lupron break. Started Lupron in august 2016. PSMA / PET shows small hot spot metastasis outside the prostate area (abdominal aorta lymph node and one other spot) CT scans and bone scans still clean. My psa went as low as 0.1 before I went on the intermittent Lupron holiday.
One MO wants me to start adding zytiga and pred. Another does not (because he's worried about my 30% plaque buildup in 3 small periphery arteries and the effect of the zytiga on leg swelling, high blood pressure, increased triglycerides, potassium impacts etc.) My cardiac stress test went very well two weeks ago. Doc thinks no increased plaque since two years ago.
Here is one list of zytiga side effects from a website: "Common side effects of Zytiga include: decreased serum potassium, increased serum aspartate aminotransferase, increased serum triglycerides, fluid retention, and hypokalemia. Other side effects include: hypertension. See below for a comprehensive list of adverse effects."
I eat really healthy, exercise 5-6 days a week. My coronary artery disease is due to heredity + possibly not keeping my triglycerides down over the years. I only have HDL levels of ~28 trying to clean my arteries.
I don't really like the idea of going on the zytiga/pred combo but based on the recent studies, it seems like I might live a few years longer (nobody knows for sure of course) if I add the zytiga/pred.
I'm leaning towards adding the zytiga/pred if I can get insurance to cover, but I wanted to get one last set of thoughts from those of you who have had similar situations and got advice from top notch MO's around the country. I realize that the side effects of zytiga are unpredictable but just curious what people on Zytiga think. So far, most of you taking it say they tolerate it well but I'm curious if those who didn't respond well are just not chiming in with their thoughts and experiences.
I apologize to those of you who have already read similar posts from me but it's a big decision. I'm also calling today to get an appointment with a 3rd MO.
thanks in advance and sorry the post didn't end up being short.