Lupron and xygeva only: My friend , 8... - Advanced Prostate...

Advanced Prostate Cancer

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Lupron and xygeva only

My friend , 82 years old , was diagnosed with stage 4 PC with Mets and lymph nodes. His first injection was firmagon on October 4, 2018. Then OC switch him to lupron and xygeva every 3 months on 11/6/18. Oncologist said every 3 months will work for him instead of monthly.

Here are his PSA readings:

10/4/18 947

11/6/18 267

11/20/18 90

1/8/19 22

Readings on 11/20/18 and 1/8/19 for liver function:

AST from 76 to 49

ALT from 83 to 52

Alkaline Phosphate from 275 to 138

Is lupron and xygeva every 3 months a good treatment plan for him?

Are the results very good? It seems like his PSA drops 70 % each month if I am calculating correctly.

Should zytiga be added or is the liver results just a little high for zytiga treatment?

Thanks for reading and looking forward to any comments.

17 Replies

I forgot to add his Gleason score is 8 for 6/8 biopsies. 2 biopsies were 3 +4

Also his calcium level has increased from 11/20/18 to 1/8/19 lab results . In normal calcium range .

I forgot the word ‘best’ in front of friend. My very best friend....

Welcome. Your best friend is a lucky guy. He has you as a friend. That's a great drop in his PSA from 947 to 22 in 3 months. His AST looks to be still a bit high ...They really watch the LFT's with Zytiga....... I gotta wonder what his PSA will be in February...Has he had a bone densitometry study??

You have joined a forum with lots of knowledgeable people.... read pjoshea13 and Nalakrats for info on supplements, studies, etc...lots of info here....Exercise helps and diet changes also....many here eat no red meat, use a low carb or keto diet....

Lots to look at for you....Happy reading and Good Luck to you and your BFF....


That is a very good response so far. Yes, 3-month shots of Lupron are just as good as monthly shots. His AST and ALT levels are now within normal range, so he can try adding Zytiga or docetaxel (if he has multiple metastases - you didn't say how many he has). He should also talk to his oncologist about adding Celebrex - the combination of Celebrex and Zometa (similar to Xgeva) has been shown to increase survival by 22%

Normal levels of AST and ALT may slightly vary depending on the individual laboratory's reference values. Typically the range for normal AST is reported between 10 to 40 units per liter and ALT between 7 to 56 units per liter. Mild elevations are generally considered to be 2-3 times higher than the normal range

HP - I'm new here at this forum, but Fish is right - keep looking and reading and thinking outside the box...look at the PC numbers but don't forget the other readings that are more immediate indicators of general health.

If you seek a direct answer, in my experience of 2+ years of advanced metastatic PC (um, numerous bone mets is an unfortunate reality for me), what you are describing is the current "standard of care" (ADT + "bone-modifying agent") in the early rounds (time frames look right, too) least it has been "standard of care" for me as a sprightly 50-something.

The later stuff - Zytiga and Xtandi - may come, but that isn't for today. Be a friend. Take Fish's advice and walk your friend down to have a salmon or trout dinner, talk, laugh, enjoy today and have hope for tomorrow. Regards, Joe M.

NPfisherman profile image
NPfisherman in reply to SeosamhM

You gave some great advice....laughter is the best medicine....that and time with loved ones...2 are a warrior...I am a MO put me on zytiga and Lupron....1 bone met--recently removed.....I am getting a bone densitometry study this month at 60.... this diagnosis was my birthday present in November...hope I can lose that present someday....

Best of luck to us all...


SeosamhM profile image
SeosamhM in reply to NPfisherman

Coincidence! Yah, I literally got my diagnosis on my 49th. As I came to realize, it was a really horrible present at the time, but every day since has been the best gift I can imagine, since the whole thing started with a broken neck (dodged a bullet, there)! I was a smart-aleck before, but now I'm unstoppable! Just today, I got the news that I'm moving on up to Zytiga... Keep on fishin' everybody!

SeosamhM profile image
SeosamhM in reply to NPfisherman

Fish - I didn't even know they could take out bone mets! You think one of the ever-excited and positive 30-something oncologists would've mentioned it to me!

NPfisherman profile image
NPfisherman in reply to SeosamhM

I had stereotactic radiation--3 sessions ---highly complex--they used my auxumin scan and several other scans to confirm tumor size--several physicists calculate the radiation dose--it is double checked through a computer several times---they used a cast of my upper body and strapped me down to hold me in place...not for the claustrophobic...there are several radiation trials at NCI--oligometastatic (< 5 lesions) and there is a proposal to do COMET-10, up to 10 lesions...

I believe that this will also be a significant part of fighting prostate cancer due to SABR-COMET trial, and future trials. My insurance initially said no, but my RO wrote an appeal and it got approved...

SeosamhM profile image
SeosamhM in reply to NPfisherman

Okay, this really helps me make some sense of the confusing early days of my diagnosis. Almost immediately, they sat me down with the radio-oncologist and she asked me if my big spine lesions (C2 and L2) "hurt," since radiotherapy is only supposed to be palliative. Within a week I started 15 rounds of radiation over 3 weeks (with the dreaded head cage you mention). Based upon your narrative, I think that they must have done a serious end-around insurance, since pain was not the issue and I can assure you that they cooked both lesions, especially C2 (C2 is a jumbled mess and C3 is effectively dead).

My wife has often wondered if radiation was more harmful than beneficial. But after reading your reply, I'm beginning to think it saved my life. Thanks for the information!

in reply to SeosamhM

I like your style SeosamhM....

Oh laughter is not a problem. He has a great sense of humor. Also he has a very good outlook in life .

His first bone scan in October 2018 , 2 weeks after his first treatment which was firmagon and xygeva injections.

The bone scan results showed Mets :multiple bilateral ribs , manubriim sternum, bilateral mid shaft humerus, right numeral neck, cervical/ thoracic spine , left acetbuln, calverium mandible, and bilateral lilac pelvis . On scale of one to ten with bone minimal bone Mets at One , where would he be on the scale?

Calcium level before treatment was 9.1 and now at 9.8 so it seems like the bone Mets did not do too much damage on his bones . Is this what it means by calcium reading? ( calcium 19-9 was done once before treatment and showed high of 43.9 - don’t know what this means)

As far as alkaline Phosphate, before treatment (October 4, 2018) was 273 and now at 135 on 1/8/19. What does the decrease of alkaline phosphate mean? Is it the lupron that is lowering it?

Both Alkaline phosphate and AST have decreased by 50 to 60 %compared to before treatment October 4,2018 until 1/08/19. AST now 49 , Alkaline Phosphate at 135.

Hemoglobin reading ranging from 11.7 to 12.8 . Is that dangerous to have such low hgb?

He firmly believes that one creates and believes in ones reality . You have to decide what you want in life . So everyone , please believe that you will be healthy.

Forgot to mention that testosterone level lab work done once on 11/10/19 after one month of first injection of firmagon. His next testosterone reading is feb 12th when he gets his 2nd 3 month lupron shot.

in reply to

Testosterone level was less than 12 after one treatment of firmagon

NPfisherman profile image
NPfisherman in reply to

Sounds like the overall trend is going the right way....good for him...

"Oh laughter is not a problem. He has a great sense of humor." A 1936 KIND OF HUMOR?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/10/2019 6:40 PM EST

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