Zytiga and Firmagon

[Je1234]

Today my dad went back to the oncologist for his monthly Firmagon shot. The dr had wanted to stop all treatments at the end of January because he said that his PSA had gone from 161 in November to over 550ish. My brothers and me asked the dr to at least give him a chance on zytiga and today his PSA was 370. The dr. Was surprised but continued to give him his Firmagon shot and zytiga. Dad’s blood test came back good. Hemoglobins are at 12 now. His potassium was low and he has a uti.

[Tall_Allen]

if his potassium is low, he may not be taking enough prednisone.

[Je1234 in reply to Tall_Allen]

That’s good to know about the prednisone. I’m always stressed out because before we had the tests done the doctor had the “I doubt there’s any hope for your dad” talk with me. It’s so frustrating.

[Cmdrdata in reply to Je1234]

I think you should consider another doctor. Preferable a medical oncologist specialist in PC and with with more advanced knowledge of what new treatments are in the works. For your doctor to not even consider Zytiga until you asked is HIS ignorance, and to say “there isn’t any hope” is downright stupid. He doesn’t care about his patients. Greedy doctor.

Sorry for my rant. I hope and assume that your dad is physically and emotional well to continue treatment and still enjoying life and family.

[Je1234 in reply to Cmdrdata]

As soon as he’s able to leave the care facility we will be checking out a new doctor.

[tango65]

If he has a low postassium, he may be retaining fluid and may have an increase of the blood pressure. Consider to monitor weight for rapid weight gain and monitor blood pressure.

He may need more prednisone. If he is taking 10 mg of prednisone you could discuss the possibility of adding Inspra (eplenerone) which is a specific inhibitor of the aldosterone receptors. Aldosterone may be elevated when taking Zytiga and it can cause low potassium, edema and hypertension.

[Je1234 in reply to tango65]

Thank you. We go back on Monday for another infusion so I’ll ask about that. I wonder if his rapid weaning of the high doses of soulumedrol and prednisone this week contributed too? He was dropping From 120mg down to 10 with in 12 days.

[tango65 in reply to Je1234]

It could be possible that the hypokalemia was caused by the high dose of methylprednisolone (120 mg) and it is not related to Zytiga.

rxlist.com/solu-medrol-drug...

In general 10 mg of prednisone are enough to control or supress the excess of aldosterone which could be caused by Zytiga.

[Je1234 in reply to tango65]

Yes I need to figure this out because I don’t think the dr is putting too much thought into it.

[whatsinaname in reply to Je1234]

Its really sad that patients and their relatives have to do the work that "doctors" should be doing. That to with just a small amount of knowledge gleaned from websites and cancer boards.

[cesanon]

Am I missing something here?

Doesn't this call for chemotherapy?

Or maybe lu177?

[Je1234 in reply to cesanon]

I’m not sure what’s next. My dad was pretty sick and hasn’t been home since January due to pneumonia that just got cleared up. We had a choice to discontinue all treatments and utilize hospice or continue treatments trying zytiga and prednisone and see if he could regain some strength and go home. We were afraid that cutting off treatments would not give him options if the bone pain starts back up because at least he gets relief with that and right now he doesn’t have pain. If he doesn’t rally soon we are going to have to make some decisions because we all (including dad most importantly) would like him to be at home with everyone around him. I hate that cancer is the only dx that a person is forced to discontinue treatments to gain services. I wish we could pick dad up and move him safely but he’s been in bed and having trouble with strength since the pneumonia.

[cesanon in reply to Je1234]

Why not chemotherapy or lu177?

[Je1234 in reply to cesanon]

The zytiga brought his psa down quite a bit over a 10 day period. They didn’t think he’s strong enough for chemo. I need to discuss the lu177.

[Cmdrdata in reply to Je1234]

I just responded earlier on the doctor. But it seemed to me if I am him, at this stage, I’d like to be relieved from pain, and have a QoL that I can have with my family until it is time to go, even if I have to forego further treatment except for pain. I have seen my family members with PC and surviving for a year or two being a ”vegetable” with drugs after drugs to prolong life without being able to enjoy his family. Not the way I’d like to go

[Je1234]

If he is physically able we will try to get another cancer center to evaluate him. He’s very weak and in a skilled nursing facility for about another week.

[Je1234]

The doctor told us 4 weeks ago when he was admitted to the hospital they thought he would have 1 or 2 weeks left to live. He was dx November 25 2018 psa 166 terrible bone pain in the spine. We definitely knew if he got over the pneumonia (which he did) we wanted to try whatever we could for treatment to prevent bone pain. He got radiation Firmagon and casodex in November.Bone pain was eliminated but psa increasesd when he was tested January 21.Started zytiga and prednisone after pneumonia cleared up February 7 2019 and psa dropped from over 550 down to 370.

[j-o-h-n]

What is your Dad's age? Where are you located? treatment center? doctor(s) name(s)? This will help us help you.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 5:17 PM EST

[Je1234 in reply to j-o-h-n]

76 Bayhealth Dover Delaware Dr Sawhney. Zytiga prednisone Firmagon

[j-o-h-n]

Thank you, can you get to an oncologist that *specializes* in "Prostate cancer"?

Remember, God is on your side.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 7:26 PM EST

[Je1234 in reply to j-o-h-n]

Taking any and all recommendations from the East Coast region. God is with us.

[j-o-h-n]

can you make it to New York City?

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 9:31 PM EST

[Je1234]

Depending on my dad’s physical condition. As of today I would say no, but if he rallied and wanted to try it would be a 3.5 hour ride.