Failing Zytiga

[Ladysingstheblues]

Hello warriors: Looking for guidance..My husband has been Stage IV since 2012. He has been luck that he has responded well to his course of treatment. Unfortunatly

he has stopped responding to Zytiga. His P.S.A. is now at 5.4. steady climb over the last several months. They want to rescan and take it from there. Any thoughts or suggestions. I feel like he is reaching the end of his line for treatment and I'm scared to death. He takes Lupron and Xgeva shots, also. Has doe Radium 233 and basically everything else accept chemo. He also did Provenge. Any help would be appreciated Should I be worried...

Thank You,

Deborah

[Tall_Allen]

Why didn't he do chemo? It's tragic that the best is too often saved for last when it will do the least good. There have been case studies where it restores sensitivity to Zytiga or Xtandi. But perhaps there is a medical reason?

[Ladysingstheblues in reply to Tall_Allen]

When he was diagnosed the early chemo studies had not been released.

[Tall_Allen in reply to Ladysingstheblues]

Ah - that explains it. So then that would be the probable next step, assuming his status is good.

[dlestercarlson]

I did Zytiga and then Xtangi for a total of about 2 years which ended last September. Since that time I get a Taxotere (docetaxel) Chemo treatment every 3 weeks, I just finished my 13th treatment today. The first couple of treatments were pretty bad, now that I know what to expect, I try to minimize the side effects as they come up. So now it is pretty routine for me. I even schedule on my calendar the days that I'll rest a little bit more. My own attitude about dealing with cancer every day is that my attitude along with the willingness to fight will keep me alive and in fairly good health for many more years to come. I have been dealing now with prostate cancer since 2005 and Stage IV since 2011.

Good Luck

Dennis

[Ran2599dy in reply to dlestercarlson]

It is interesting nobody has mentioned using Avodart, a statin and metformin. The rise in PSA maybe coming from free T and not total T.

[Ssiddy in reply to Ran2599dy]

Hi. Can you explain the difference and impact of free T and net total T?

[MelaniePaul in reply to dlestercarlson]

Hi Dennis.

That is wonderful that you are able to take this combined Chemo treatment for such a long time. You were diagnosed only two years after my husband and therefore I believe you too have gone through all sorts of treatment before you started Chemo. My husband, unfortunately, only had 8 rounds before his body couldn't do it anymore. I hope it will work for a long time for you. Mel.

[snoraste]

I imagine he’s done his genomic profiling. Any targeted therapies an option?

[Dan59]

You did not mention xtandi, which to me would be an option. I got over 2 years on xtandi after zytiga failed. Also chemo is a good option, not everyone gets all the side effects. I have done 18 over the last year and a half, and will be getting the 19th next week when I return from Holiday in Europe, As Dennis stated above there are ways to minimize the side effects and it may work well. He looks to be young and strong in the picture.

Good Luck

Dan

[Hidden]

He could still get a good benefit from doing Taxotere chemotherapy. Like many others, I was intially afraid of doing it but found a lot of encouragement here and elsewhere. I want to encourage you not to fear chemo. Taxotere is one of the easier chemotherapies in terms of side effects. Most people tolerate it quite well. Taxotere got my PSA down to .19, the lowest it's ever been and the only time during my treatment when I was completely pain free. I did lots of activities, including work while doing chemo.

Doing chemotherapy could also make you sensitive again to Zytiga or Xtandi.

Good luck with treatments. I'm hoping for the best outcome for you.

[MelaniePaul]

Hi there.

Yes, unfortunately, that can happen. I suppose you should consider Chemo as your next option. It is a difficult journey, but hopefully it will help your husband fight the cancer.

Good luck to you both!

Mel.

[Hidden]

There is still Casodex. Xtandi and more.

[Jlow53]

Conventional treatments for my husband also stopped working so we requested molecular profiling of his removed prostate. Then a company named CureMatch in San Diego will analyze the results and recommend a treatment based on their database of all FDA approved drugs. You should look into this type of precision medicine analysis.

[jrr02]

Has he had his prostate removed? Has he been diagnosed with metastisis? and where. If PSA is rising and he still has his prostate, that is a question, otherwise identifying what is causing the PSA to rise will probably give a better direction for next steps. I had radical in 2008, targeted radiation in 2009 with Casodex and Eligard next six years, Bone scans and MRI have identified minor mets in L3 spine and scapula. Neither has grown or spread, but PSA went from <1 to 6 in a year and went on Zytiga with Prednizone and continued Lupron with Denosumab quarterly. PSA came down and dropping slowly over last 9 months. "A Drop is a Win!" Good Luck!