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Advanced Prostate Cancer
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TURP and Enzalutamide advice

Hi everyone,

I'm dealing with widespread metastatic PCa at 50 years old, diagnosed last Aug. I'm on Enzalutamide now (plus Lupron since Oct) but not responding very much after almost 3 months πŸ˜”. PSA still rising (84 last week, up from 72)... also... really feel like crap a lot of the time on this second-line hormone therapy (first two months weren't too bad) with brain fog, fatigue and anxiety.

I can pee slow but OK (maybe 50%) and without pain but my main issue is that my bladder retains most of what I drink during the day for some reason (why is this?) and then the nighttime is terribly disturbed with between 3 and 8 visits to toilets (well, I have glass jars next to my bed for convenience!).

Prof DeBono at the Royal Marsden in London (where I was referred to recently for a second opinion) wants me to have a TURP done so that they can get tissue samples (never had a biopsy cos I refused a year ago) to enable them to genetically sequence my disease to figure out if I am eligible for a particular PARP drug. I did post in the recent thread about TURP but no-one responded.

Considering seeing DR. Ettienne Callebout in London as the I need more root cause diagnostic work done. Anyone seen him?

Help very much appreciated!

6 Replies
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Get the Genetic Testing--on the way get a Chromogranin A---> test to rule in or out Neuroendrocrine Pca cells. I do not see where you were scanned. Get blood tests, on T, Alk. Phosp. RBC Counts, Kidney Function, and Blood sugar.

Nalakrats in the States.

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I think the TURP will help you pee better. And a great idea to do a genetic analysis on the tissue to see if you would respond to a PARP inhibitor. Ask if they can biopsy a more distant met at the same time - sometimes there is DNA-repair deficiency in distant tumors but not in the prostate. They do have some serious side effects, but they work very well in some men. DeBono is certainly among the best anywhere and is plugged into most of the major clinical trials.

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Thanks for that. Sorry I never responded at the time. Do they generally keep you on ADT (I'm taking Lupron and Enza with limited results) when you take a PARP inhibitor?

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Yes - you are on Lupron for life. Some men prefer an orchiectomy.

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Have you tried peeing in a sitting position, I find this the best way to squeeze every last drop out of my normally retentive bladder before going to bed. Had two TURPs in my time, if you do have one done then don't be too alarmed at possible blood and 'bits' in urine for a few days! All in a good cause.

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I take Flomax and Finasteride for urinary issues with Stage IV metastatic cancer....works for me great.....hope that helps......

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