My Story

[ellyras]

I was diagnosed March 2015 with mestatic prostate cancer Gleason 9. I've had 6 cycles docetaxel chemo and radical radiotherapy to the prostrate, pelvic lymph nodes and left pubic ramus. In 2018 I started enzalutamide which, sadly failed after 3 months. November 2018 I started cabazitaxel chemo but halfway through the cycles, the PET scan showed new bony disease so it was abandoned. ironically the cancer in my prostate is completely dormant. I can have radium 223 but would prefer to try Lutetium -177 first. Also another patient told me that abiretherone had better results than enzalutamide but I was offered no advice, only told to choose one or the other. I am an NHS patient so not sure they would allow me to have abiretherone having made my choice. Apart from some fatigue and a bit of discomfort in my right hip I feel fit and well but feel as though my options are running out. I am now age 67.

[Magnus1964]

Everyone responds differently to ADT drugs because each approaches the problem in a different direction. If xtandi failed you should be able to move on another, i.e. casodex, zytiga, etcetera.

[ellyras in reply to Magnus1964]

Thanks. Well we will ask but as a NHS patient they are pretty strict ie its one or another

[Tall_Allen]

There is a trial in the UK comparing enzalutamide to abiraterone. When one is resistant to one, there is usually resistance to the other as well.

Radium 223 is especially a good choice if there are few bone mets. Why do you prefer Lu-177-PSMA-617 first? The randomized trial of Lu-177-PSMA-617 may be on hold in the UK- check with the trial administrators. You can get it in Germany.

[ellyras in reply to Tall_Allen]

We were advised by a senior consultant that if you can get Lut 177 it was better to have this first as its more effective then, after a 6 month hiatus, you can have Radium. There may be a trial starting in the UK but if you get on the trial you only have 2/3 chance of getting the Lutetium. The remaining 3rd get "next best treatment" whatever that means.

[Tall_Allen in reply to ellyras]

No one really knows if Radium is "next best" or "better" than Lu-177-PSMA-617 for bone mets. As you can see in the chart in the article below, Radium 223, an alpha emitter, has superior cancer-killing power. There are also trials for PSMA-targeted Ac-225, which is a more powerful (but shorter range) alpha emitter.

pcnrv.blogspot.com/2016/08/...

[ellyras in reply to Tall_Allen]

Thanks for this article. If I get on the trial and if radium 223 is "next best treatment" then it makes me feel I wont be disappointed.....

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

to ellyras,

Well, we know you're 67 years old, In England, and in the National Health System. Thank you for the information. But I know something else about you. You'll be around to celebrate your 87th birthday and die from lack of breath blowing out your birthday cake candles. Trust me I'm always right.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/18/2019 2:34 PM DST

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

Thank you. I promise to do my very best. And I sincerely hope you're around too in 20 years time as well.

[DSEE in reply to ellyras]

Just so you know.... I am Gleason 9 DX 2015-

Failed Radium 223 after 3 treatments due to extremely low hemoglobin .

It worked very well until then.