Zytiga and Predisone

[billkw1]

My oncologist is recommending adding Zytiga and Predisone to Lupron, which I have been taking since February 2016. I am concerned about bad side-effects from these new ones. I feel pretty well now. Any thoughts?

[JamesAtlanta]

I added them both back in December when my PSA started climbing. No significant side effects and my PSA has been undetectable again for 6-months.

I would not worry about the side effects ... the benefits should far outweigh them. Just make sure you eat right and exercise.

Best of luck!

James

[Mkeman]

I have been on same regimen for 8 months with few overt side effects. You need to be alert to silent longer term issues like loss of bone density and muscle mass as well as cardiovascular damage. Ask for periodic bone

density scans and occasional EKG. If you can get a referral to a physical therapist he/she will develop a program to help you maintain muscle and bone strength...

[zenbee13 in reply to Mkeman]

I just met with my Oncologist and asked:

If you know that I have to work out 3 times a week for 1 and 1/2 hours just to maintain my current muscle, and bone mass; Why don't I have a prescription for physical therapy for that?

And knowing that I have to do that why don't I have a prescription for a Gym membership, so I can write that off on my taxes?

And knowing that it is unsustainable for you to have Gym membership to do these type of work outs during the week, why don't I have something for my work that stipulates that to accommodate my disability (Cancer is considered a disability)?

And knowing that neuroscience shows that exercise releases endorphins and can by itself relieve depression. (Who doesn't get depressed with this beast?) WHY, WHY, WHY?

I got stuttered excuses that didn't hold water any better than I can hold my pee since the prostatectomy.

I may be looking for a new Oncologist soon.

Ask the hard questions, and insist on being taken care of in a manner that addresses all of you.

Peace my brothers,

Never stop fighting the beast!

[j-o-h-n in reply to zenbee13]

Get a new oncologist... (someone with a heart) mention where you live here and for any recommendations in your area. These guys know plenty of them.

Good Luck and Good Health.

j-o-h-n Wednesday 07/18/2018 5:24 PM EDT

[Trecento in reply to zenbee13]

Oh boy do we sympathise! Logic flys out the window. And yes, we need to challenge the (appallingly unintegrated) cancer system. The bone situation is extremely galling. My husband will switch from Xtandi to Zytiga (with predisnolone) in two days = Warfarin, Zolodex, Zytiga and Pred all consolidating bone and muscle loss. We are exploring removing Warfarin so that the bone issue can be addressed and will discuss with a practitioner supportive of alternative/integrative therapies. Thanks to helpful members here on strategies (nattokinase/serrapeptase). The addition of pred has really thrown a spanner in the works in terms of supplements that seem to have been effectively supporting Xtandi (on the basis of visible evidence) but can no longer be used safely because of interactions. I would like him to continue with XTANDI - anyone used Bdenzi sourced from India? can't guarantee genuine generic so very risky, but not >$4000 AUD per month. Reason for moving to Zytiga is that onco says it does same but cheaper, because used with pred. Can it be used without pred? Concerned about suppression of immune system when many supplements are for supporting/rebuilding the immune.

[john205 in reply to zenbee13]

The short answer to all your questions: INSURANCE COVERAGE

- Insurance will not cover PT for an established exercise program such as you described

- Gym membership coverage depends on what your insurance will cover - some do, some do not

- Disability coverage is not based on diagnosis but on functional status and your job description. If you can do that much exercise, the disability insurance carriers will probably not consider you to be disabled. But maybe you can work something out with your employer for flexible time to use the gym

Having said all that, you must make your own choice about your oncologist...but it is nice to have one who is on your side and will advocate for you. Many docs balk at the burden of filing appeals with insurance companies, but there are also many who will do whatever it takes. My experience is that the larger, established cancer centers generally have processes in place to do that sort of advocacy.

Good luck

[Ldb01 in reply to Mkeman]

Our first Oncologist told my husband to join a Pilates class.....

[Schwah]

I’ve been on lupron Zytega for 10 months and by doing weight training hard three days a week I feel pretty darn good. Key is studies have shown that Zytega with lupron early as possible extends life by about 40%. Gotta do it.

Schwah

[dorke in reply to Schwah]

I second that.

been on Zytiga for a month while working out and swimming ~5 days a week.so far no noticible side effects.

I believe working out is crucial to manage SE

[pkafka]

Like the others have stated; exercise makes all the difference. I'm on my second go around with ADT and this time with Zytiga added to the Lupron. I can't believe how well I am tolerating it this go around. I even had to ask my doc to run a testosterone test on my psa check last week because I thought I had too much energy for being on these drugs. But it came back less than 3 which essentially says Zero!. I did find that the Zytiga did increase my blood pressure into the pre-hypertension level. Doesn't have this effect on everyone. But keep an eye on the BP. I hope to take it until the end of the year and then take another ADT holiday after my Proton Beam rad. for recurrence.

Be Well, Stay Stong & ENJOY!

[Scruffybut1]

I have been on Zoladex (lupron) since Jan 2015 starting with 10mg Predominantly now reduced to 5mg. Stayed on it thru 8 months of chemo and still on it. In fact today I get my 3 monthly shot..

Zytiga added Sept 2016 and still going strong nil side effects. PSA ranges 0.03 to 0.05. Damn good results. Good luck.

[Trecento in reply to Scruffybut1]

I guess this question is to all of you on Zytiga - do you all take prednisolone with it?

[Scruffybut1]

Bloody predictive....I wrote starting with 10mg pred.

[George79]

I got a good 18 months from zytiga and prednisone without appreciable side effects. Good luck.

[milto27xabc]

Started Zitiga and Prednisone Oct/17--contniued Lupron every 3 months--PSA dropped from13 to .05 . Then in Dec/17 my elbow swelled to size of tennis ball and took 2 months to get back to normal Started a 20 minute weight program every 2nd day 3 months ago and it tends to reduce fatigue a bit. The extreme tiredness really bothers me but the PSA results are worth it if it stays low.I'm 86 so maybe the side effects are age related!

[TomNew62]

Ask to try XTandi I’ve had very little side effects with it and great results for bringing down my PSA.

[Cancer09]

My husband had no side effects and felt great on these two meds along with lupron ...but then they didn’t work either after 6 months

[Hidden]

I'm confused! Why use both Lupron and Zytiga?

Doesn't Lupron stop Testosterone from just the testes?

Doesn't Zytiga alone stop all Testosterone from testes, adrenal glands & cancer cells?

Thanks, Clint

[Kevinski65 in reply to Hidden]

Xtandi and Zytiga were designed as an add on to Lupron, degarilix or some other androgen antagonist. They can't do the job alone. I believe genetics dictate how long they last. I'm 6 years out on Lupron and Xtandi. Diagnosed PSA 31, stage 4, M1, Gleason 9, 3 bone mets, a few questionable lymph nodes. Doubling time is 5 months. I also take Zyflamend for prostate. I also take things to help depression one of which is despramine. Aspirin, lipitor, atenolol also I am taking and help slow things down. I am now at .03 PSA, bone Mets undetectable, lymph nodes neligible as far as cancer goes. Side effects , weight gain, loss of labido, depression, fatigue, short term memory loss. That's about it. Is it worth it? I have grandkids and love to see them so what can I say? Kevin

[TommyTV]

I’ve been on this combination for 6.5 years. The only major side effect has been severe muscle wastage in my legs. PSA @ Dx was 571, it’s been immeasurable since 12 weeks after commencing treatment 6.5 years ago.

I also take Lanzaprozole to protect my stomach.

[Jirka in reply to TommyTV]

Can I ask you when did you take Lanzaprozole? Before zytiga or after.....I mean your daily routine..my dad fights with stomach pain as a side effect of zytiga. Maybe Lanzaprozole could be helpful. I would like to know your personal experience. Thank you for your reply. Take care of yourself.

[TommyTV in reply to Jirka]

Hi

Approaching 9 years on Zytiga next month!

I take Lanzaprozole, 5mg Predisolone and Candestarten (for BP) at 9 am every morning with breakfast.

At 11 am I take 4 x Zytiga. I then have lunch anytime after 12 noon.

At bedtime I take another Lanzaprozole and a statin.

My phone has an alarm for the 11am Zytiga as I’m usually working, and forget to check the time.

That regime has worked great for me. Very, very occasionally, I take a small amount of Gaviscon at night if I’ve eaten hot chilli or curry.

Good luck, hope you have as much success with Zytiga as I have.

Martin

[Jirka in reply to TommyTV]

Thank you so much for your answer. I really appreciate it. You are so kind. It is really nice to read that zytiga could be so helpful.

[dlestercarlson]

I took Zytiga and predizone along with the Lupron shot for about 18 months. It was not to bad. The biggest and most consistent side effect was fatigue. So I just planned every day to take time for a nap or two.

[Olivia007]

My 80 year old dad has been on all 3 and doing well. No major side effects . Psa has been low which is great news to us. Good Luck! You Got This!!!!

[Hidden in reply to Olivia007]

Hi Olivia007. My dad has been on Lupron, Zytiga and prednisone since November and feeling great. Just recently he has 2 small jumps in his PSA from .2 to .6 and then to 2. He will have a blood test again in 2wks and I’m praying that it is stable or goes back down. Has your Dad’s PSA fluctuated at all?

[ITCandy in reply to Hidden]

Ask his Doctor about taking Zytiga with a high fat meal. Greater absorption of the drug may bring his psa down again.

[Hidden in reply to ITCandy]

Thank you. I will most certainly ask about this.

[j-o-h-n]

Well Bill I guess the Yeas have it!

Good Luck and Good Health.

j-o-h-n Tuesday 07/17/2018 6:05 PM EDT

[leo2634]

Hi Bill been on Zytiga,Prednisone going on six months now, along with six month Eligard injection and only side effects are hot flashes which are tolerable,and ED Which is so far managed. Drink a bottle of Spring water on an empty stomach with the Zytiga, I take mine around 6am: and Prednisone around 9am after Breakfast. PSA was 14.7 to now undetectable in a month from starting ADT still the same so far. Keeping active is very nesasary even if only a nice walk everyday.

Never give up never surrender. Leo