Zytiga + ADT OR Taxotere + ADT?! Advice please.

[guardian5]

Hi! I’ve been lurking in this forum for the past two weeks and have been really impressed by the knowledge and hope here. My father was recently diagnosed with Gleason 9, PSA 999, heavy burden. It’s been a total emotional rollercoaster for the last month. We saw two doctors over the past week and one wants to start him on ADT + Zytiga, while the other wants to start him on ADT + Taxotere. Seems like results from going with either option are pretty similar. Outside of cost, does anyone have thoughts on pros and cons? Experiences that can be shared from their own decision making process? Thanks so much.

[Schwah]

Both combinations have been proven to extend life when given together sooner rather than later. That’s why my MO recommends all 3. And that’s what I did. Nothing yet proven that that is better but so far use of most PC drugs have proven more effective given earlier. Logic dictates that if A + B is better than A or B alone and B + C is better than B or C alone than wouldn’t A + B + C work best ? I asked for a second opinion at ucla and they said “it seemed logical”And they’d “love to see a clinical trial” but without proof they can’t recomend it at this time. I took the leap of faith. Fight the monster with all you have while it’s weaker. It worked so far for me so far (down to .02 PSA) and others on Dr Scholz office and my insurance pays for all 3. But the choice is yours and your doctors. If I had to go with just two I’d go with Zytega ADT. Numbers seemed slightly better.

Schwah.

[AlanMeyer]

I think Schwah's (and Dr. Scholz') choice of using all three was an interesting one and I hope there is a clinical trial of it. Until there is, I understand the position of the UCLA doctors in being unwilling to recommend it. When chemotherapy was first discovered it was believed that "more is better" and many cancer patients were given as much chemo as they could stand without actually dying from it. Many suffered permanent side effects. Later studies showed however that huge doses of chemo were not better than much smaller doses. There is an amount that is effective. Less was less effective but more didn't add anything.

I think if it were me I'd go for the Zytiga over the chemo because, for most men, it's not as onerous a therapy. But that's not true for everyone. As with so much about cancer treatment, it's a crapshoot.

Alan

[fredfrange]

contact these folks--just received this blast from Asia--

Prostate Cancer moved into the bone structure--we have had him on very high amounts of products for this issue for 90 days --after 90 days here is his latest labs collected on 08/24/18---starting lab numbers--90 days ago--Glucose-121-now 75--alk phos 1035-now 452-Platlet count--257-now 194 --psa 270-now 0.02 -- --we still have a ways to go to get the cancer completely controlled/remission in the bone structure (with an alk phos of 452) but we have the cancer well under control and the alk should be back in range within the next 60 days or so--of note: typically the alk phos will remain high for a time period even after the psa falls to undetectable levels as the cancer is much harder to remove from the bone structure as opposed to stopping the growth in the flesh---very expensive to get this done (a large amount of product) cost well over $2000 usd per month--but as the client said- Quote--I would have likely been dead by now if I had continued with the medical and was getting worse by the day thank GOD I had the money to fund these products to get these results and most of all they are available- I have no pain whatsoever --unquote

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[AlanMeyer in reply to fredfrange]

Fred,

I wouldn't trust the email blast from Asia. It may be true. It's more likely a lie written purely to get money. There's no easy way to tell. However, even if it is true I'd bet dollars to donuts (do donuts still cost less than a dollar?) that the very same treatments are available here in the west, but are safer and more effective. Some years ago Chinese "herbal" treatments were being sold in the U.S. that seemed to significantly reduce PSA. When they were analyzed by labs here in the U.S. it was found that they contained prescription ADT drugs in addition to whatever herbs were in them. However, unlike prescriptions in the U.S., the composition and dosage varied from batch to batch. You never knew what you'd get and certainly never knew if it was the best thing for you.

Alan

[fredfrange in reply to AlanMeyer]

do you ask a dr what is in the crap drug they are giving you--come man--get real--

[fredfrange in reply to AlanMeyer]

Sir i have been on their products for over a decade--how do you think i have stayed alive-- i was trying to help save some lives with the info--i do not work for them--they have been in business over 18 yrs and even offer a money back guarantee to lower psa and as you know if the cancer has already spread to the bones --you have to lower not only the psa but it is a must do lower alk phos leves --this protocol has done this time and time again..Fred

[AlanMeyer in reply to fredfrange]

Can you post the exact ingredients of the product? If it's a legitimate product there should be a drug label that says exactly what's in it. You should also be able to post the name and address of the company.

And yes, I do find out exactly what's in any drug prescribed for me by a doctor. I don't have to bother asking the doctor to explain it, everything is in the drug "label", often found in the package insert and always available on the Internet at the FDA and National Library of Medicine websites. The FDA labels are often around 30 pages in length and show the specific ingredients, the chemical formula and structure, the mechanism of action, the known side effects, the nature and results of the clinical trials, the recommended dosages, and so on.

If this stuff you are recommending is legitimate, there should be similar documentation. If there isn't, and you are really taking this drug, and you have reason to believe that you have prostate cancer, I recommend that you see a doctor who specializes in prostate cancer.

I don't understand everything I read in the drug labels but I do understand some of it and I trust it one hell of a lot more than "blast emails from Asia".

Alan

[fredfrange in reply to AlanMeyer]

--product all natural but but much stronger than any drug for prostate cancer--would give website to look at but your people who monitor this blog will not allow it--

[AlanMeyer in reply to fredfrange]

Fred,

I think I see what you're talking about. There was a Chinese drug available in the U.S. about 15 years ago called PC-SPES ("spes" is latin for "hope".) It was banned by the FDA because it was found to contain a number of prescription drugs including warfarin, diethylstilbestrol, and indomethacin, which are all illegal to buy without a prescription. PC-HOPE is an herbal remedy, I think from the same source, but supposedly without the prescription drugs. See this web page from Cancer Research UK: cancerresearchuk.org/about-...

PC-SPES was studied in the west and appeared to work in a similar way to hormone therapy. The UK web page doesn't say whether it worked better, worse, or about the same as the prescription drugs in the US and UK, or whether the side effects are better or worse. I understand that diethylstilbestrol worked and used to be used in the west but was dropped because the newer hormone drugs worked better and had fewer negative effects.

One of the problems with PC-SPES was that the formulations were different in every batch that was analyzed by the FDA. I don't know if that problem has been overcome with PC-HOPE or not. According to the Cancer Research UK page, PC-HOPE appears to have some anti-cancer activity, but no rigorous trials have been done and we don't know whether it is as good as prescription drugs like bicalutamide (Casodex), leuprolide (Lupron), etc.

If it's working for you, I fully understand that you want to continue taking it and to tell other patients about it. But, unless you took Lupron and/or other prescription drugs and they failed you, you shouldn't conclude that PC-HOPE works better. It may be better but it may not. You might be doing just the same on Lupron. I know one man who has been on Lupron for 15 years and another for 20 years, both in remission the whole time.

You must understand why you have gotten so many hostile replies to your posting. There must be thousands of sites on the Internet offering "alternative" treatments for cancer. The vast majority are out and out frauds, make ridiculous claims like "98% cure rate" and "no side effects", and contain fraudulent testimonials and references to non-existent studies. How can someone protect himself when dealing with these claims. Anyone can say anything he pleases on the Internet and there are millions of people who would be perfectly happy to take money from cancer patients while letting them die, as long as they couldn't be sent to jail for it. Checking them out by taking the pills or whatever is dangerous and might postpone life saving treatment.

I believe the safest and most rational course is to stick with science. It ain't perfect, but it seems a lot better than the "alternative".

Best of luck with your cancer.

Alan

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

Aren't you the same fredfrange who was shot down when you posted "control prostate cancer with ease". You remember cause it was only yesterday (August 28, 2018, the day you signed up for this group) when you were pushing that anguis oil.

Good Luck!

j-o-h-n Wednesday 08/29/2018 7:02 PM EDT

[fredfrange in reply to fredfrange]

i spoke with this man here this is not just something made up--it came to me through a blast email from these people in Asia --i do not work for them -i want to make this very clear..Fred

[Tall_Allen]

With a heavy burden of mets, I would consider Taxotere first. My reasoning is:

1. Taxotere and Zytiga have the same DEGREE of side effects (Grade 3-5), although they differ in kind

2. When compared among men who were randomly assigned to one or the other, there was no difference in survival

3. A typical course of Taxotere is 6 infusions every 3 weeks, so it would be 18 weeks before you could switch to Zytiga. Whereas if you start with Zytiga, it may be more than 4 years before resistance sets in and he can try Taxotere.

4. Taxotere has been known to reverse the genetic resistance to Zytiga in some men. So doing Taxotere first may allow Zytiga to work longer.

5. Taxotere extends survival more when there is a heavy burden of mets. Zytiga has not been tested for a heavy vs a light burden of mets.

I discussed all this and other options in the following article:

pcnrv.blogspot.com/2017/06/...

I do think that what Schwah is doing (both at the same time) may turn out to be optimal, and it is obviously doing well for him. But I agree with AlanMeyer that that strategy is best done in a clinical trial. The downside is that one may get both sets of side effects at the same time. If you decide to go that route, make sure your insurance will cover it.

[Noel91]

Chemo improved survival un high burden mPC.In low burden I think Zytiga is preferable.I would check Latitude, Stampede and Chaarted to find Out what would be more suitable un this case.

Don't know about common side effects but they depend on the patient.Father is currently on Zytiga and he has minimmal side effects and some men here, are Also doing well with Chemo.

[DaughterOnAMission]

Had the same petrifying decision to make for my dad. No one in my family does any research, I went to every meeting very informed... but had trouble picking also. UCLA said Zytiga plus Lupron/Pred. KAISER said Taxotere & Lupron. Scary to decide but we went with Zytiga because like TallAllen said it could be 4 years before resistance. So, chemo seemed harsh with my dad's few Mets. My hope is that they don't grow and suddenly cause regrettable consequences... I don't know if I made the right call. Heavy burden. But he was 17.75 and now .9 in 3 months. Hoping he'll stay low for a looonnnggg time. He has changed his diet to mostly fruits and veggies, and takes all the major supplements. He is incredibly positive. I need him around forever. Every person and cancer is different. Hard to know what path to take.

[HopingForTheBest1]

One month ago I started on a 3 month Eligard shot and daily Zytiga with prednisone pills. i had initially started with a 30 day Firmagon shot two months ago. Minimal side effects that can be dealt with. PSA down from 20 to 0.5. Alkaline Phosphatase down from 248 to 133. MO initially recommended ADT + Taxotere, but after researching it further he prescribed my current treatment and saved Taxotere if necessary down the road. As for cost of Zytiga, I was lucky that my OptumRx plan covers it.

A generic for Zytiga was just approved by the FDA called Yonsa.

[fredfrange in reply to HopingForTheBest1]

Zytiga will only work for 4 months at best- --it only cost about $50 bucks to make it--this is sad --Ins/medicare kills so many people as they fall into the medical trap..

[HopingForTheBest1 in reply to fredfrange]

Not sure where you got the 4 month effectiveness from. Numerous participants on this forum would not agree, nor does my MO.

[fredfrange in reply to HopingForTheBest1]

seen many men use this drug -which by the way it is the new version of provenge -the company that went under some yrs ago.. only works on less than 20% of men with advanced androgen independent cancer-- sad results

[Dan59 in reply to fredfrange]

Provenge and zytiga are 2 totally different types of drugs, both have shown increased survival in prostate cancer in Randomized controlled clinical trials, Your information is wrong and misleading, to me similar to your pc hope claim. We are used to guys signing up with unbelievable claims on their first post on the first day they are on the list.

[fredfrange in reply to Dan59]

you are correct--i made a mistake--used the provenge (now called elagard) something) after i used the hormone blocker Zytiga -back then it was called lupron and solodex neither worked for me.. sorry for the error- Fred

[maack1]

Either procedure is reasonable, but abiraterone with ADT medications is unlikely to have as significant side effects as chemotherapy/docetaxel with ADT medications.

In the paper below titled “Comparison of Abiraterone Acetate and Docetaxel with Androgen Deprivation Therapy in High-risk and Metastatic Hormone-naïve Prostate Cancer: A Systematic Review and Network Meta-analysis” and with the following objective: “To perform a systematic review and network meta-analysis of randomized clinical trials, indirectly evaluating overall survival (OS) for men treated with abiraterone acetate plus prednisone/prednisolone with ADT (Abi-ADT) versus docetaxel with ADT (Doce-ADT) in hormone-naïve high-risk and metastatic PCa.” The researchers/authors concluded that there was no statistical significant difference in overall survival between patients treated with abiraterone(Zytiga) and ADT medications and those treated with docetaxel/Taxotere and ADT medications. They also concluded that from another analysis there was a high likelihood that abiraterone/Zytiga with ADT medications was the preferred procedure.

europeanurology.com/article...

[leo2634]

My Doctor started me on Zytiga,Prednisone and,ELIGARD along with Xgeva for bone Mets that's was six months ago. So far so good PSA undetectable after just a month.

[fredfrange in reply to leo2634]

what is your alk phos levels-- i had a friend some yrs ago that had a psa of below 1 and died with and alk phos of over 4,000.

[Hidden in reply to leo2634]

Keep it rolling!

[fredfrange]

no --i was giving people on this blog valuable info but all i got was a bunch of bad response--one person called it snake oil--it saved my life--and do you are anyone else on this blog think that company that has been in business over 18 yrs could still be selling snake oil (and with a money back guarantee also) come on--so much trying to help someone else.. Fred

[fredfrange in reply to fredfrange]

i do not intend to you any more advise on this blog--by

[Hidden in reply to fredfrange]

There are sharks in the water..don’t sweat the negative comments.. each to their own beliefs.

[leo2634]

I have my blood work done every three weeks to a month and all my results are in the normal range and PSA is undetectable going on seven months now.

[jholmq]

I've read that hormone therapy with Zytiga produced better outcomes with fewer side effects. My onco put me on this in January and so far it has worked really well. Chemo will always be available later. If TallAlan reads this post he'll have more detailed information on the studies involved. If he doesn't respond send him a message, and maybe get a 3rd opinion.

[fredfrange]

i told you i have been taking their supplements--i am not a liar -- --go to their website and ask them these questions--fred--

[fredfrange]

i only used lupron and then tried the provenge (now called elagard) -neither worked for me--all i have done in the last 12 yrs is take these supplement from Asia. they dropped my psa and alk phos very low within 30 days.. been well under control since then. those things above is the only thing i did medically..Fred

[fredfrange]

correct in over 12 yrs--go to their website and ask them anything you would like to..i am living today because i found these people..Fred

[fredfrange]

keep in mind these people do not take everyone that comes to them--they have a huge waiting list--i know they would not like it if i told them i advised someone to contact them.. they have more clients than they can get to--they are a world wide company now for over 18 yrs..

[Hidden]

So far it’s worked for me...good luck to you...This is when a pc specialist is needed. My urologist told me chemo and adt, but my specialist spared me chemo and I did just adt & RT. So far so good.. each different, you’ll do the right thing.. Rollercoaster! That’s my word for APC... initial fear and frustration was horrible but with some luck and time he shall make it thru to a better day. A lot of prayers!

[Bob10]

How old is your dad ?from my reading ADT and taxotere..seems to be standard of care..I'm at Dana Farber and just received my fourth chemotherapy treatment no real bad side effects just hair thinning..