What next after chemo fails - Advanced Prostate...

Advanced Prostate Cancer

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What next after chemo fails

JanJames profile image
19 Replies


This is my first post, we live in UK and my husband Steve was diagnosed with aggressive prostate cancer in 2011 with lymph node involvement. PSA 14, Gleason 10,

Started 3 monthly zoladex injections straight away which he still has and also 40 radiotherapy treatments which kept his PSA to around 0.6 for 4 years.

He then started Casodex but it did not work so he was prescribed Enzalutamide, this worked well for almost 2 years but then PSA started to climb and scans revealed bone mets and he had 5 Radium 223 treatments. Further scans showed spots in the abdomen.

Last October he started chemo (Docetaxel) but PSA continued to rise and after 4 cycles oncologist said it was not working and changed to Cabazitaxel. PSA dropped after the first few cycles but then began to rise after cycle 4 and 5, PSA currently 20.

The oncologist is very negative and implies that there are very few options remaining, he has not had Aberiterone but onc says this rarely works after enzalutamide fails because thay work in a similar way. Has anyone experienced this?

Any advice or suggestions would be so appreciated as I am very worried that we are running out of treatment options


19 Replies
Tall_Allen profile image

Sometimes Zytiga will work again if it is tried after Jevtana. He can try estrogen patches too. If you can afford to go to Germany for treatment, they have had some good success with some radiopharmaceuticals (eg Lu-177-PSMA).

JanJames profile image
JanJames in reply to Tall_Allen

Thank you so much, will look into this, any idea of a good cancer centre in Germany?

Tall_Allen profile image
Tall_Allen in reply to JanJames

There are several in Germany, and I think that the top centers cooperate on nuclear medicine, but the one that seems to have the most experience is Uwe Haberkorn at the University of Heidelberg. Contact details on the following:


ctarleton profile image

You might also look into some more "out of the box" things in the UK research specialist world for advanced prostate cancer. Perhaps seek a second opinion from the very top prostate cancer research specialists in the UK as to your Options. There might also be possibilities for genetics testing of cancer tissues for possible matches to certain actionable genes with drugs or agents still in Clinical Trials. These links might help facilitate such conversations and searches.



Just some thoughts...


gusgold profile image

after zytiga there is Apalutamide, Darolutamide, and Proxilutamide

Ssiddy profile image

Also have a look at care oncology clinic in London

Costarica1961 profile image

Sorry to hear of your roller coaster ride of emotions. Zytiga with predisone. Has that option been presented to you.

JanJames profile image
JanJames in reply to Costarica1961

No because oncologist believes it will not work because enzalutamide failed eventually

wongle profile image

Hi where are you in England my hubby is Steve also x

JanJames profile image
JanJames in reply to wongle

Hi We are in Somerset not far from Bristol

wongle profile image

Hi where are you in England my hubby is Steve also he is on chemo we are in West Yorkshire

Rmanns profile image

Have you experienced these yourself?

Rmanns profile image

I'm having trouble finding research that shows Zytiga or Xtandi being effective again after it stopped working. Can you give me a source? I'm in the same situation as JanJames' husband.

JanJames profile image

Thank you very much so much useful info to follow up

JanJames profile image

Thanks that is a great idea

wongle profile image

This desease is so bad hubby just been taken to hospital not been eating so tired I just don't know what to think anymore

Godschild62 profile image

My husband was diagnosed with stage 4 with bone Mets from the beginning. They put him on docetaxel first which only lasted and few months, then he went on Zytiga for only a month- cancer spread like crazy for him on that- did not with for him. He's now taking a new chemo drug called cabazitaxel and this seems to be working very well for him right now. PSA dropped from 1098-34 after 4 treatments. Best of luck, and God bless!

scarlino profile image

Sorry but I too struggle with same issues.,Cancer has been in lymph nodes. Taxotere didn’t work and stopped after 4 infusions. Began Jevtana. PSA dropped after 1st infusion but after second it rose again though very slightly and a bone met was found on one of my ribs (first time this happened). Last infusion I started Carboplatin along with Jevtana, which I just had this week so not sure what it is doing. Extra fatigue, but I continue to have no pain anywhere, which is a blessing.

Currently my PSA is 142. In medical terms this cancer sucks.

TomMaloney profile image

The new PSMA/Pluvicto (Lutetium-177) has worked wonders for some.

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