newLy diagnosed April 10 2018

67 with Gleason 8 psa of 4.25. Started on casodex and lupron at KU Med. Went to MD Anderson and was switched to Zytiga. Just waiting for the tumor to shrink away from my rectum. I’m sure it is in my rectum because the tumor is outside the prostate up against it. Just waiting. Seems to be the way of this disease. Take a pill and come back in 3 months. Both hospitals same plan. Is it typical that the drs. say little or nothing. Certainly makes you think the worst. Both have positive attitudes. Going with MD Anderson.

[AlanMeyer]

Normally, doctors will try to determine if the cancer is "local", which means it's all in the prostate or very near by, or "metastatic", meaning that it has established itself in parts of the body that are distant from the prostate. Have they told you whether they think the cancer is local or metastatic?

Is the PSA of 8 a reading from before treatment or from after treatment with casodex + lupron? If after, they probably think you're metastatic. If so, the addition of Zytiga to the Lupron is the current "best practice" for treating it.

You might want to learn more about all of this. Here's one place where you might want to start: cancer.gov/types/prostate/p...

Best of luck to you.

Alan

[Hidden in reply to AlanMeyer]

They have not been clear to this point. My next visit I hope to get an answer. I think.

[yamobedeh]

Your numbers seem similar to mine at Dx. I had a large tumor on one side of the prostate and a smaller one on the other, but no spread to adjacent tissues outside. You didn't say whether or not you had an MRI or other scans in the area of the prostate, or if you have metastasis vs other aspects of tumor growth. I had a suspected bone met so my Dx was upgraded to stage 4 a month later. Before that I was prescribed Casodex. After that , they stopped Casodex and put me on Lupron 3 month. I was not at all satisfied with their treatment plan, which was basically wait and see to palliative. After intensive research, I went to Dattoli Cancer Center where I was offered much more intensive treatment with curative intent. I was on ADT triple blockade with Casodex, Trelstar ( like Lupron but less allergic to me) and Avodart. Also had 37 RT sessions, Brachytherapy and follow up RT to pelvic lymph nodes. Also taking a number of meds, supplements and foods with anti PCa effects. I think you should connect with a medical or radiation oncologist specializing in PCa asap if you're not there already. I got moving on intensive treatment options after becoming aware of the now-accepted notion that aggressive combinational treatments are associated with better outcomes, and my ROs at 2 different hospitals both did not offer more than wait-and-see or palliative treatment, despite being aware of new treatment guidelines. And they differed significantly on the treatment plans they outlined. My PSA and testosterone levels are undetectable currently and I am off Casodex and Trelstar as I monitor the levels over the next months and hopefully, years. There are members here with extensive medical and biochem experience as well as Valuable PCa experience and advice/suggestions. Good luck with your case.

[Hidden in reply to yamobedeh]

Mine was out of the prostate. Still not sure what that means for me. MRI showed the tumor against the rectum and they used the word invading the rectum. Going back to md Anderson this month for another MRI. Lonely disease. No answers. Mostly take this pill and come back in 3 months.