Thought I would share my experience on these meds.
Briefly: Age 59, Gleason 7, Stage IV, diagnosed 2005, not encapsulated
Treatment: Lupron 2 years, brachytherapy, 36 radiation
As PSA would increase back on Lupron for a year.
While on Casodex/Lupron PSA continued to rise. No mets. PSA almost quintupled to 13.4 in 6 months.
Started this holy trinity on my birthday, 18 January. After 2.5 weeks my PSA was 4.4. After 6 weeks, my PSA is now 2.8! Freakin amazing.
Lupron (I believe this is my 5th round): depression, fatigue, hot flashes and then I get cold.
Erleada/apalutamide: fatigue, it has decreased my need to urinate as much!
Xgeva: joint pain, nausea, headaches
Compared to the results, the side effects are a small price to pay.