Increase in bone Mets?: Today we met... - Advanced Prostate...

Advanced Prostate Cancer
8,701 members9,776 posts

Increase in bone Mets?

DSEE
DSEE
25 Replies

Today we met with oncologist after bone scan and CT.

Significant increase in bone Mets.

We knew something was off because of pain.

He has done Taxotere , Lupron, Xgeva and was entered into a clinical trial but got out of trial because he was so very sick.

Now Zytiga and PSA is down but increase in bone Mets is huge.

New lesions in ribs spine femur arms

Pelvis sacrum.

Anyone have this experience?

25 Replies
oldestnewest
Tall_Allen

Have you discussed Xofigo? He would have to come off of Zytiga first.

1 like
Reply
DSEE
DSEE
in reply to Tall_Allen

I wanted you to know my oncologist added Xofigo with Zytiga . Someone on this forum posted the Bayer (maker of Xofigo)warning

on combining the two drugs.

Oncologist immediately took off Xofigo injection.

So only one dose went in combining the two drugs.

You would think they would know this!

Reply
Tall_Allen
Tall_Allen
in reply to DSEE

I'm surprised he didn't do it the other way around - take you off Zytiga since it is no longer working.

Reply
DSEE
DSEE
in reply to Tall_Allen

The thing is..... PSA is down on Zytiga and bone scan showed increase in Mets.

The increase in Mets was enough that he felt Xofigo was warranted but he did not want to discontinue Zytiga.

I ended up on both!

Then warning was discovered.

Reply
Tall_Allen
Tall_Allen
in reply to DSEE

PSA is not the best measure of success when there are multiple bone mets - bone alkaline phosphatase and radiographic evidence are important too. If all other indicators are higher, but PSA is lower, it might mean the cancer is mutating into a form that doesn't put out a lot of PSA.

Reply
DSEE

We were given that as a possibility by PA.

Oncologist to call Monday.

Have you known others and what does it mean I wonder that Mets increase and PSA drops?

Reply
Rmanns
Rmanns
in reply to DSEE

Look closely at Xofigo. Anecdotally l had a poor outcome and so have many I've been in contact with online. My pain did not improve, my PSA shot up scans showed little impact on bone Mets.

2 likes
Reply
Charlean
Charlean
in reply to DSEE

The radiologist told us that the mets are there for a long time before they are big enough to see in scans so its possible the growth occurred awhile ago and just now visable, hopefully. If the PSa went down, seems the meds have helped. Best wishes.

Charlean

1 like
Reply
MontyB

I was taken off Zytiga after PSA started to increase and scans showing a progression in some bone Mets. Next for me...my MO ordered Xofigo.

1 like
Reply
DSEE
DSEE
in reply to MontyB

The odd part is that PSA declined and Mets increased greatly.

Reply
MontyB
MontyB
in reply to DSEE

Yes, that is odd. How was the ALP ?

1 like
Reply
DSEE
DSEE
in reply to MontyB

ALP was also sky high.

How long did you take Zytiga?

Reply
MontyB
MontyB
in reply to DSEE

One year.

Reply
Drcrunch

Maybe mutated to neuroendocrine.

3 likes
Reply
gregg57
gregg57
in reply to Drcrunch

I was wondering that too. Neuroendocrine cells do not express the PSA. He could check his Chromogranin A and NSE (blood tests). If that's the case, I'd want to look out for visceral mets.

Neuroendocrine prostate cancer (NEPCa) represents a minor population of PCa, yet NEPCa cells exists in the most advanced stages of PCa (6). Importantly, the population of NEPCa cells might increase during the current ADT with anti-androgen treatments (7). Different from most PAC cells, NEPCa cells express little androgen receptor (AR), thus they are inherently resistant to the ADT treatment. The common markers for these NEPCa cells are Chromogranin (ChrA), neuron-specific enolase (NSE) and synaptophysin (8).

Source: ncbi.nlm.nih.gov/pmc/articl...

Reply
Nalakrats
Nalakrats
in reply to Drcrunch

Best possible analysis.

Nalakrats

Reply
dbroyles9002

Sounds like what happened to me. Hugh increase in bone mets was causing a lot of pain. MO started me on Xofigo two weeks ago (still on Zitiga as well.) About a week after the first treatment, I started getting relief from the pain! This stuff is really working well for me.

Reply
DSEE
DSEE
in reply to dbroyles9002

They mentioned Xgofigo.

Please let me know side effects.

Reply
gregg57
gregg57
in reply to DSEE

Here's a link to the prescribing sheet which has the results from the clinical trial that was done prior to approval. It has all the details on side effects experienced by all the trial participants:

accessdata.fda.gov/drugsatf...

Good luck with your treatment, I will probably also be doing Xofigo next.

Reply
larry_dammit

Wow. So sorry to hear of the new Mets. That worry’s me as I get new pains Dailey. Hang in there and fight a good fight.

Reply
gregg57

How are your other liver enzymes such as ALT, AST and Bilirubin?

Reply
DSEE

ALT and AST high

Have not checked bilirubin

Reply
gregg57
gregg57
in reply to DSEE

Bilirubin is generally the slowest to be effected. How high are your AST and ALT? The high ALT and AST could be from Zytiga. Did they go up after you started Zytiga?

Reply
DSEE

Yes those tests did increase after Zytiga

Reply
Patrick-Turner

I had a few bone mets 14 mths ago, but 2 mths ago I had dozens. So scan is beginning to resemble dalmation dog, spots everywhere, but no pain yet.

I begin Decetaxel on 17th, 10 doses max, at 3 weeks apart.

I have no idea of taxotere will reduce bone mets but I can get Lu117 and maybe radium 223 within 6 weeks of ordering it. Nobody is talking about Xofigo here.

Psa is about 8 now, after Zytiga failed, rising fast. No visceral mets yet, just bones.

Cycling 200km a week still, and working in my shed doing craftwork.

Once Pca is in bones, relationship with Psa can get hazy, but most guys with high amount of Pca in bones have high Psa. If bone mets don't make Psa, a man can't get a fix with Lu117. Maybe with Radium 223, not sure, I think I have 5 years, onco says 8 years.

Nobody really knows.

Patrick Turner.

1 like
Reply

You may also like...