Tomorrow my best friend will have a blood test and follow up with his MO . He is a prostate cancer specialist from USC Norris Cancer Center so he is very competent . Two weeks ago MO was thinking about adding zytiga but because of increase alk phosphate and Alt , he decided to wait . My best friend asked if radiation and chemo will be considered in the future. MO said he doesn’t know
Today I read more on his CT scan results . He has many lymph nodes ( no biopsy) present . I recall MO did not want him to have radiation or chemo but just have hormonal therapy . Is this about right? Is this based on his age?
Will firmagon and zytiga together be enough for the many Mets on his bone?
He is a relatively healthy 82 year old man who made it through skin cancer, bladder cancer and vocal cord cancer over 20 years ago .
Hoping his PSA will be much lower tomorrow . He already dropped from 948 to 267 in two weeks with firmagon.
i would ask why not to start Zytiga if the alkaline phosphatase is going up. The increase in alkaline phosphatase may be an indication that the disease is progressing. They can monitor ALT and see what happens if he is treated with Zytiga. There is not a significant difference between Zytiga and chemo in his situation. Some doctors will consider chemo if there are more than 4 distant metastases. The issue of longevity vs quality of life and acute side effects of these therapies should also be discussed.
What was the ALK PHOS at diagnosis, and now? It can definitely go up initially, before it goes down. That's actually fairly common at the beginning of ADT treatment, especially if it was already high at diagnosis.
I think highly of the MOs at USC Norris, and know several men who are patients of Dr Gross. It sounds like they want to see his liver enzymes stabilize before deciding, which is prudent. Firmagon + Zytiga is a very effective combo for shrinking all those metastases. The doctor will decide on Taxotere or Zytiga based on his status. Radiation would be palliative if he is in pain from bone mets, or is in danger of spinal compression. He can ask about Zometa + Celebrex.
"82 year old man who made it through skin cancer, bladder cancer and vocal cord cancer over 20 years ago." WOW God bless him or should I say God blessed him...
Question to his MO. Can he match the good results that he had from his prior cancers?
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