Is Zytiga working for my Significant other?

Diagnosed in late October 2018. Lymph nodes and mets on many areas of his bone, Gleason 8. 82 years young.

First shot was firmagon than it was 3 months Lupron. PSA before treatment was in mid 900 early October 2018. Lupron alone only brought his PSA to 20 and he stabilized there.

1/8/19 (PSA 21.43)

1/29/19 (PSA 20.36)

2/12/19(PSA 21.55)

Zytiga (1000mg) and Prednisone were added February 14, 2019 as his liver enzymes are normal and PSA stabilizing.

He went to see his GP on March 8, 2019. His PSA is at 20 and serum testosterone (first time ever tested) is less than 3 . He is disappointed that his PSA did not come down after 3 weeks of Zytiga. Also, he is not at .2 for serum testosterone.

He can handle the truth.

So please, is Zytiga working for him or not? Is a serum testosterone of 3 good or not? (His total testosterone has been less than 12 ng/dl)

How long should it take for his serum level to be at .2?

I thought Zytiga should work right away in lowering the PSA?

[Hidden]

Forgot to mention that on March 8, 2019, after 3 weeks of Zytiga, his ALT is 29, AST is 34 and alkaline Phos is 126 ( last month was 134 before Zytiga)

[Magnus1964]

It might be to soon to say. Sometimes patients have what is called a PSA bounce.

[Zetabow]

I suppose everyone responds differently, 55 years diagnosed Nov 2018,Gleason 9, extensive Mets and Lymph nodes, I'm on my second injection of Diphereline, Firmigon, 10mg Prednisone daily and I've had 3 rounds of Chemo so far, PSA was 1386 in Nov and now it's down to 4. Next Chemo on the 20th.

Don't know the difference between Zytiga and Diphereline, if one is newer than the other or cost any different, or it's basically the same drug and just a different name, maybe someone who knows can enlighten us.

[Garbonzeaux in reply to Zetabow]

Diphereline is a polypeptide fairly closely related to Lupron. Zytiga is a synthetic steroid, so not nearly the same thing.

[Hidden]

Thanks so much for responding. I don’t want to start a new thread . His GP said his blood test in February 2019 show problem with liver so he had an ultrasound . Report came back that they need to investigate around the pancreas area and doc said it is urgent . He is supposed to go in for scan March 18th . His appointment with MO is on March 19th . Should he go for the scan as radiation would feed the cancer? Should he wait to see MO first?

[Hidden]

Just spoke with him . He said doc found images on ultrasound outside pancreas 12-15 mm in 3 places which may be a tumor. Doc suggest he goes for scan on March 18, 2019. Is this necessary as the radiation would feed the cancer?

[Tall_Allen]

Give it time. it can take a few months to have an effect. He has to assess the impact on tumors as well as PSA.

[Hidden]

Thank you. I am an anxious person. Actually , the CT scan ordered by his urologist already showed the tumors. It has shrunk already. Hope Zytiga will work for him. Also, hoping the tumors near the pancreas will be maintained.

[leo2634]

I've been on Zytiga for a year now and PSA has been undetectable since first month treatment so give it time. It's not a wonder drug but has worked wonders for me hopefully will do the same for you.

[Bebby1 in reply to leo2634]

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[Hidden]

Does Zytiga work well for those who have many bone mets and lymph nodes?

[leo2634 in reply to Hidden]

I have multiple bone Mets,lymph nodes affected last scan showed significant improvement and some lymph nodes undetectable now. I'm also on Eligard and Xgeva as my total treatment.

[jedgar1]

It took me 6 monthes to get to undetectable on zytiga and lupron from 1.96

[Kezza2]

When I started Zytiga, PSA was 5.17. 4 weeks later it was 1.33 and continued falling to a low of 0.12 after 28 weeks. No side effects, until Zytiga failed at 2 years. Tried Xtandi but it didn't work. Have just finished 9 rounds of chemo but that hasn't worked either so Lutitium 177 is next