AlanMeyer

I know that elevated levels of liver enzymes can be caused by hormone therapy. It happened to me and to others. I don't remember the numbers that I had but I think they were worse than your friend is experiencing. If I remember correctly, my ALT went up by a factor of 3 - though I had no symptoms. In my case I had just had one more 3 month shot of Lupron when the blood test came back. I never developed any liver related symptoms but was not given any more Lupron after that.

Sometimes it resolves on its own. The body apparently adjusts to the changed circumstances. I have been told that it might sometimes be possible to switch to a different drug to suppress the influence of testosterone, e.g., Casodex or Xtandi (a very effective drug.) Non-hormone treatments, e.g., docetaxel chemotherapy, are also a possibility though they have severe side effects for some (though not all) men.

Best of luck.

Alan

Hidden

Hello, and welcome “Best Friend”.we all need one of those. He must be a good man to have your caring friendship.. “very healthy til 80” I salute him. I am sorry that he has this..but you will find all you need to know about pc and then some.. Thanks for being a friend that cares.. You friendship and compassion might be his best medicine as well. God Bless!

ctarleton

It's a very good sign that the PSA response is so good after less than a month on Firmagon. With the wide-spread "mets", the Firmagon alone will likely do a lot to suppress typical prostate cancer cells, and to keep bringing those PSA test results to lower and lower numbers over the next several months, and possibly lasting for many months afterward. The injection of a bone preserving drug like Xgeva (denosumab) or something similar is also very typical for those with many bone mets. Having "put a damper on the prostate cancer fire", so to speak, there is likely time now for the Oncologist and other specialists to watch those other conditions/drugs/test results for a while, and to "tweak" things a bit before possibly adding "early Zytiga" or "early Chemo" to the mix. Being a relatively healthy 82 years old to start is a big plus on his side, already. Having such good friends and caregivers is Priceless!

Welcome!

Charles

j-o-h-n

A friend in need is a friend indeed. God will bless you for helping your friend.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/17/2018 12:46 AM EST

8knots

I had elevated enzyme numbers on Zytiga (also on Lupron). MO took me off to watch the numbers. They finally came down but MO said it took the longest of any of his patients. Gave me the choice of Lupron only or Lupron and Docetaxel. I go for third round of chemo this week. Liver numbers are good again but I was disappointed to not be on Zytiga longer. I preferred Zytiga over Docetaxel but that is just me.

HPpurple

Thank you kindly for all your input and taking the time to reply. I read my friend's CT chart more carefully. It seems like he has lymph nodes in the kidney, throat and chest area- all confined in the bone area

Will Firmagon destroy the lymph nodes?

Hopefully Firmagon with the addition of Zytiga added will be his treatment. However, what is the next line of treatment should the hormonal drugs not work anymore?

Is Lupron ever used after Firmagon stops working?

Thanks all. My friend is very chill but I am the one stressing.

hansjd

Two things in relation to what you have posted:

a) Firmagon has been shown in a long-term (5-year) study to be superior to Lupron (Leuprolide) in PSA progression free survival and in controlling ALP.

ncbi.nlm.nih.gov/pubmed/246...

onlinelibrary.wiley.com/doi...

b) an initial rise in ALP often occurs - it's a sign of bone repair.

hansjd

Has it been suggested that your friend start chemotherapy (docetaxel)? It's been shown to have significant beneficial results with minimal side effects when given early after diagnosis, with ADT, especially for metastatic patients. It is now the 'standard of care' treatment.

onclive.com/publications/on...

ascopost.com/issues/march-1...

Good luck.

HPpurple

Hansjd- no suggestion of chemotherapy. He has many bone Mets and lymph nodes with extremely high PSA. When he asked , oncologist said hormonal treatment for several years , then try something else.