Dx 15 months ago age 40..
1250 PSA. lots of Mets. 12 rounds of Chemo and Lupron over the year. stopped working so started zytiga. after 2 weeks PSA went from 80 to 17... what can we expect next ...have read that dramatic drop means it wont last long. trying to stay a step ahead. Doc suggests immunotherapy if a trial comes available.
Why not wait and see where it ends up...80 to 17 is like an 80% drop in 2 weeks...I had a similar type drop in 2 weeks and it continued...lets say it gets to 4....that would be solid...at that point, you might try adding indomethacin to your mix which could drive it even lower...
ncbi.nlm.nih.gov/pubmed/277...
and could even look at switching over from prednisone to dexamethasone...
theoncologist.alphamedpress...
My advice...WAIT !!!.... who knows how low you'll go just on zytiga and prednisone...I know it's hard to relax and none of us have a day when this isn't on our mind at least once....
Be thankful...breathe....wait.... and look at those options I posted and discuss them with your MO...
BTW--How many mets is "lots of mets" ??? Stereotactic radiation trial may be an option for you also...
All the best,
Fish
Great response, it could go to undetectable like mine did after 2 months. Good luck. My doctor said a great response and a deep response is a good indicator for Zytiga working for a year or more. Mine has stayed undetectable for around 6 months now.
That's great news...Congratulations gregg57.....may it stay that way....mine wasn't high initially but fell to near undetectable in 2 weeks and undetectable quickly afterwards...I want to stay a part of "The Undetectables" for a long time....My MO has one guy who has remained undetectable on Zytiga for over 6 years... In the STAMPEDE study, I believe 40 months was the median and no maximum was listed...
I thank God for Zytiga regularly...
Fish
Me too! I love that idea of “The Undetectables” club.
Actually, the median failure free survival was 43.9 months...some did better and some did much better.... an excerpt from STAMPEDE...
“Abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%,” said lead study author Nicholas James, BSc, MBBS, PhD, Professor of Clinical Oncology at Queen Elizabeth Hospital in Birmingham, United Kingdom. “Based on the magnitude of clinical benefit, we believe that the upfront care for patients newly diagnosed with advanced prostate cancer should change.”
Change to abiraterone, of course...
Fish
That's great, I've been really happy with it so far, no noticeable side effects, undectable PSA, and an almost complete reduction in pain. Hard to ask for more than that.
Hi,
When you were initially diagnosed 15 months ago, did they check your testosterone level?
You are very young to get this crap, I suggest to read Dr. Edward Friendman's book (Amazon), it will provide a base for learning what you have and for challenging your doctors. This is paramount, have a prostate cancer specialist Oncologist on your team.
Current aggressive treatments are ADT3+, thus, Lupron, Zytiga and Avodart for example: malecare.org/does-adt3-work...
Please learn about aggressive approaches, for instance, Dr Myers, is a great resource. Don't only rely on your doc, please learn, learn and learn. Then engage here, we're real and caring patients pushing life!
Isn't Myers retired?
Yes, he's retired, but so many amazing talks on youtube and has an active information subscription service. Has advanced insights from Dr. Edward Friendman's book...
Youtube search: Dr. Snuffy Myers
I don't believe the study that says a quick drop is a bad thing. The study I'm thinking of defined a fast drop as >11 in some time period. That's big if your starting PSA is 20, but tiny if it's in the hundreds. So what they proved, IMHO, is that a high initial PSA has a worse prognosis, which we already knew.
I just saw a study with docetaxel which stratified PSA drop by half life and showed that a faster drop in relative terms had a better prognosis.
I read this site every day for info and hopeful news .. it has been my lifeline on this journey. my son is not positive about the future and maybe he is realitic but I can't give up .. Doc is at u of Chicago, pretty much standard of care . hopefully with this drop of PSA he will be willing to look forward to other treatments. again thanks to all who reply as most who go on this site are looking for advise and dont reply to the questions of others as our knowledge is so limited. so to those of you who do the research and take time out of your busy schedules a big thank you from those of us who depend on your advise in these difficult times ..
I'm relatively new to this site and cancer, but learning as fast as I can. Not being positive about the future can be a side effect of treatment. Losing testosterone is tough mentality as well as physically. My wife is frequently much more positive about my chances than I am, and I'm pretty hopeful much of the time.
Personally, I keep up my attitude using exercise, humor, psych meds, medical marijuana, and a bit of meditation. In other words, battling the emotional aspects of the disease and treatment takes at least as much effort as battling the disease itself. Before cancer I dealt with anxiety and depression, so I had a head start in learning how to deal with the emotional aspects.
One final thought: being positive is more important than being realistic (within reason).
We are eager to help you and your son in this fight!
Greetings, We know you're 41 and being treated at the Univ of Chicago. In a separate post next day (not a response to me). Would you be kind enough to tell us your location and your Doctor(s) name(s)? This info helps us help you. If you don't wish to give us that info then that's okay. Tell your son to be optimistic cause you'll be around for a very long time, so long you'll be spoiling his kids like your spoiling him by paying for his/their college education.👀
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 02/25/2019 7:20 PM EST
Have you looked into lutituim 177 phase 3 clinical trial through Endocyte.com
Where is that trial?
Go to Endocyte.com you should be able to read about it there . Dr. Luke Nordquist was the first to have people enrolled in this phase . He is located in Omaha Nebraska . But I do believe there are other locations. But with that said Dr. Luke is awesome.
What Follows Lupron and Zytiga?
Next steps after Xtandi and Zytiga 
What's next for crumbling bones when Zytiga was not tolerable?
Next step options after lupron/zytiga failed
