Advanced Prostate Cancer
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do we need scans after chemo completed

Finished chemo March 27,2018 . On loupron currently and will be starting zytiga and prednisone soon. PSA was .02 on March 27/18 on May 9/18 Pittsburgh listed it as n<.1 Are the two readings the same? No scans ordered just told to get zytiga started along with prednisone and come back in 3 mos for loupron injection. Axium Pet Scan on Nov.11/17 showed numerous bone mets and pelvic area . surgery was in july/2017 PSA was 3.4 sept.1,17 .. 10/23/17 was 8.49 and had risen to 11 on Nov.15. started loupron , casodex and prednisone nov.22/17 First chemo on Dec. 5/17 He also had 4 xgeva shots for the bones {xgeva stopped now because of trouble with bone in jaw} His cancer is Adenocarcinoma ductal type Gleason 10. Dr said with his PSA so low we should be fine almost a cure. I am still scared and want to be sure we shouldn't be doing something else. I did insist on doing the Foundation One Test.

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What would you do differently if a scan showed more or fewer metastases? If a test makes no difference to the treatment, why do the test?

The two PSAs tell you the same thing - great response to the chemo! One was the conventional PSA test, the other was an ultrasensitive PSA test.

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When I hear or read it from the people on this post I breath easier. Thank you for all the time and caring advice you give. I currently have more faith and get hope from this site. tk you

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I had a very similar diagnosis but only 3 mets, 2 in pelvis area and 1 on ribs. I did chemo , lupron zytega and prednisone as you are doing. Very agressive protocol which is good. I did one more thing however. I had radiation doses to the 3 mets. Ucla and my Dr felt that it couid help and there was minimal side affect risk. They both theorized (but no proof as yet) that by radiating the actual mets you may kick start your own immune system into attaching other unseen mets. Not Sure how or why but I did it and no side affect. Only 3 treatments. No need for scans until and if your PSA starts rising. Two much more accurate scans now out there. PSMA at ucla and usf and an acetate c-11 test in Phoenix. The PSMA tests are in a trial dai you must qualify. The one in Phoenix not yet approved by most insurance so cost out of pocket about $2500.

Schwah

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thank you that is something to look into in the future. thank you

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Your situation very much like mine. Except I am going to get 20 days of radiation on the prostate in addition to the 3 on the Mets. I love it when a plan seems to work. Good luck and good health.

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Tk you , keep me informed with your progress

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Thanks for this post. I start chemotherapy tomorrow and I will ask the MO about the advisability of irradiating the met in my lower spine. I had the FDA lifetime dose to my abdomen in 2012 after the prostate was removed, so this may rule out any more radiation. Still, thanks to your post I am going to ask the question!

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Make sure to chew on ice and dip your finger tips on ice while doing the chemo. Really helps avoid problems.

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Will do, thank you!

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and don't forget your feet!!

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Will do! Thank you.

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Good Monday Morning tallguy2,

I iced both hand and feet during 6 cycles of Docetaxel/Carboplatin chemo.

Med Onc advised to take 100mg B6 orally daily to mitigate peripheral neuropathy. Seems to have worked.

Best wishes. Never Give In.

Mark, Atlanta

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Mark,

Thanks very much. Yesterday I looked all over the grocery store for B-6...they seem to have plenty of B-12 but no B-6. Did you have to go to a pharmacy? I would like to follow your advice!

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Hi Tall,

Got my B6 at CVS. Also look for Biotene products (toothpaste, mouthwash, etc) as these help with any dry mouth issues.

Mark

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Will do, thanks!

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Day after chemo #1 and no neuropathy. What do you think...should I start the B-6 now or wait until I see if symptoms develop?

Just a little fatigued this morning. Sit have good appetite and no nausea (yet).

Thanks for sharing your advice with me!

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Short answer IMHO--yes. Coming up on 4 mo. from end of chemo. and on Xtandi. Scans scheduled for end of 4 mo. healing, settling period. CT,Bone scan, full blood work up, then meet with Drs. Hate the wait time, but had two surgeries in the mean time. Still recovering. Back to work in a week.

Good luck, don't worry too much, and get on with life as best you can. We are all in this together.

Doug

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Good luck to you

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6 rounds of chemo then to lupron and Xgeva monthly with blood panels. I wanted to get a scan after the chemo but the doctor wanted to wait 4 months then 8 months now have a scan scheduled for June 4. One year since last one, the wait is killing me , all of the PSA and blood work is good so his thought is let’s wait and see how much difference there is between them. Every doctor is different. Mine doesn’t want to waste my money.

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Good Monday Morning benninger,

Sad to say, but some scans, like Axumin, require a PSA higher than yours to find anything.

Happened to me one time, with years spent keeping PSA down, when it started to rise again, I was almost pulling for it to rise to get in limits for a scan.

Best wishes. Never Give In,

Mark, Atlanta

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Thank you for the reply. The DR. had said that after chemo he wanted to do scans to see how the bone mets reacted , Then when we meet 6 weeks after chemo he said we didn't need them. I guess my question should have been how can they tell if the bones improved with the xgeva.

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