Apalutemide?

[dadeb]

Hello all,

Dad just started Apalutamide. Already had extreme fatigue, so I don’t think side effects will add to that. So far just watery eyes.

Is there anything I can add to make the drug more effective? Is there hope of him regaining any strength or mobility? Any suggestions are appreciated.

Dx 2010 at age 70. Lupron,zytiga,Provenge,doxetel,Xtandi,Radium 223. psa <1500. Bone mets- no lymph- no pain.

[Schwah]

The key to keeping ones strength during these treatments is execrcise. Especially resistance and or weight training. Start with 2 or three pound dumbbells if need be hire a trainer even if it’s once or twice to set up a 3 day a week regimen. Lupron removed all your testosterone and muscle mass will deteriorate fast if you don’t use it. Anyone on this site who’s experienced it and tried weight training will agree I’m sure. It’s hard but worth it.

Schwah

[dadeb in reply to Schwah]

Thanks!

[mcp1941]

I agree with Schwah. Get to the gym. I worked with a trainer for 2 days a week for 2 months. Plus going on my own an additional 2 or 3 days. 30 minutes of cardio and an hour on weights. Been doing this for 15 years. I also just started Erleada about 2 weeks ago and haven't noticed being any more tired

[dadeb in reply to mcp1941]

Great to hear you’re also doing Erleada. Please keep me updated. I read a great post yesterday that xtandi reaches full strength at 28 days. I imagine Erleada is somewhat the same.

[leswell]

Hello from Jan and Les, i.e. Leswell. When I saw that I am being followed, I felt flattered. Moving on. Lovely picture. I presume you have found a few of ours. Right now, I’m about to quit the internet for the night,, but I wanted you to know that our MO says my husband’s weight lifting efforts in the garden do not extend overall survival as much as running (our MO is a recent recruit to running and has lost much weight), biking,, or swimming.

I tell him we are nearly 80, and cannot return to running 16 mi myself, knock-knees and all, or in his forties nearly qualifying for Boston as did my husband (ancient history and bragging). Reason is, Les has lymphedema caused by chemo ordered by him and could fall over a 2 ft fence. I am also nearly eighty and now have iffy feet. Nevertheless, we like this doctor.

I’m thinking (very late at night), did you say your father had Xgeva? I didn’t see it. Maybe he had Zometa with docetaxel as did my husband who is to begin Xgeva injections in September.

Your father and my husband both have more bone metastases than qualifies for oligometastatic classification, right? So, the question is, how do we lessen those bone lesions? Your father’s treatment, so far, sounds extensive and superb. I especially like your not living for a low PSA, i.e. undetectable. Should all of us with bone lesions just quit and die?

So, in my half-asleep condition, are you considering Xgeva? If not, why not? I’ll let you know how Les’s injections progress assuming Zytiga isn’t a lost cause.

Go well both of you. The garden (and the parenthesis of our 56th anniversary on Saturday) come first, but you will remain in my mind. Mrs. S

[leswell]

Sorry not to edit. Terrible.

[leswell]

More chemo is how to reduce the number of bone lesions. Question is, could your father or my husband survive more of that? I’ve decided, at my age, to refuse chemo and ADT. Many physicians, I’ve read, have chosen the same path. I prefer to die at home with as many brains as remain. How about you? Maybe when push comes to shove, i will do anything to stay alive. I hope not. Jan

[dadeb in reply to leswell]

Thanks for your thoughtful reply, Jan. Your reply’s to everyone here have been so kind, and so I appreciate reading them all. The Boston Marathon? You have definite bragging rights.

We didn’t get Xgeva-but did have Zometa and Doxetel. When we started Radium, the MO said psa would rise, so no need to monitor. Waiting for test results was so stressful, I think she was trying to spare us. At the end of the 6 treatments, the psa was sky high, he was anemic, and she said she had no other treatment options. So- we changed doctors, and took the Guardant 360, which qualified him for the Earleda. I’m not sure we can make up the lost ground fast enough, since he had nothing to fight the cancer since November until June. Really working on getting Darolutimide, but no luck so far.

Everyone here talks about finding a cancer care center with a standard of excellence, but our closest would be Seattle. The time for that would have been at early diagnoses, but I didn’t find this site until a few months ago, so it never crossed my mind to go out of state. I think we could have had many more options if we had made a change sooner. I did take him to the Huntsman center in SLC, but the MO suggested just standard care. I wonder if I should still get him to Seattle for a consult.

I agree with you on the chemo, and

I know my Dad is not strong enough for any more rounds, but what do we do about these bone mets? He has no pain, just fatigue and muscle loss. Is it time to give up? When he tells me he’s done, I’ll listen, but it’s not that time yet.

I’d be very interested to hear how the Xgeva works for Les.

Happy Gardening! Send some garden pics 🌺 Our best to you and Les.