My husband is post chemo and now has had 4 consecutive rises on Xtandi. His doubling time is 2.2 months though he is still at a low number- 2.5 (up from a nadir of .78). Dr. told us on Friday that we need to make a decision this week about what treatment to pursue next as his cancer has been very aggressive historically. We are being presented with two options:
1. Beginning docetaxel again. He had 9 rounds before with an extremely positive response. He began right at diagnosis and his last cycle was exactly one year ago.
2. A short cycle of high dose radiation. It would be 4 times over 2.5 weeks. There is no research to support this but the radiation oncologist and Dr. Courtney both seem to believe it could likely keep his PSA down for longer, not increasing survival time but increasing time until system treatment is necessary. Right now most recent PET, bone and CT scans basically show his cancer as not “active” anywhere other than his prostate.
Looking for input on choices above but also info on where we can get the most sensitive scans that are available. I know this would likely be paying out of pocket but if there is activity anywhere else that is too small to be picked up by the scans that he has had at his PSA level, I feel like we need to know this to make a truly informed decision. At diagnosis cancer was throughout lymph nodes up to diaphragm, and in bone marrow and bones throughout axial and appendicular skeletal bodies. We are confused, struggling, looking for guidance.
Thankful for this group and any thoughts, ideas, input!