My dearest S.O. (82 years young) saw the MO yesterday. Zytiga and Prednisone was added to his Lupron and Xgeva on February 14, 2019. 1000 mg Zytiga and twice a day 5 mg of Prednisone per day.
Here is his PSA since the beginning of his treatment:
10/4/18 - 947.50
11/6/18 - 267.60
11/20/18- 90.4
1/8/19 - 21.43
1/29/19 - 20.36
2/12/19 - 21.55
3/19/19 - 18.66
Since February 14, 2019 to March 18, 2019 , his PSA dropped from 21.55 to 18.66. MO said Zytiga is working and he should stay with the treatment plan. Any thoughts or should the plan be more aggressive?
How well is it working? Does anyone think PSA will go down a lot further by May 7th?
MO also changed his twice per day 5mg of Prednisone to once per day? Does anyone know why and if this is a good idea?
(His kidney and liver functions are all normal except for Potassium which is a tad above normal)
His next appointment is May 7th for the Lupron 3 month shot and blood work.
His MO is Dr. Pinski from USC Norris Cancer. He has a consultation with Dr. Lam in Marina Del Ray in mid April. Same office as Dr. Scholz. S.O. has no pain whatsoever. In fact, he is looking good with also a change in his diet to fruits and vegetables, no meat products.
Agree with Magnus's idea, I put out info on SABR-COMET-10 trial... there were several replies and some information about stereotactic radiation in the post---
May 2018 my psa was 1230. Have had two 6 month lupron shots. Started zytiga sept.2018. By feb 2019 psa was down to .82 and it brought alkaline phosphatase from 782 to 121. I'm happy so far with only this treatment.
I am hoping to get some remission with Abiraterone, which I started approx 12 days back. Will test my PSA, CBC, RFT, KFT, etc, etc tomorrow for the first time after starting Abiraterone. My last PSA had more than doubled to 11.7 after completing 6 cycles of pure poison (docetaxel)
Can I ask the dosage that you are taking of zytiga ? My Dad’s got lowered from 4 to 3 tabs nightly since his BIllirubin was rising along with his alkaline phosphates. He started zytiga on January 31.
The reason he is getting a lower dose of prednisone, is because his potassium is a tad above normal. Everyone needs a slightly different replacement dose.
The Zytiga has stabilized his PSA at a lower level, so there is no need to make changes. They will want another bone scan eventually to confirm that. There are lots of medicines available for him when it stops working.
Hi, Ive been at this since 2004 but I do not have advanced PCa.
Is your dad castrate resistant meaning at some point someone said hormones do not work.If so my friends take a low dose DES.
Prednisone is a steroid not meant for long term use. He cut it back to protect your Dads body. With the latest readings it appears the PSA is being maintained at a certain level.
Thats good and I dont see it dropping further. It needs to go lower.
People are also using Metformin. .if a drug works it drops the PSA down like crazy.
It was working in the beginning very well but now its not so good
Another thought on the prednisone. Normal body physiology for the adrenal hormones is a burst once a day in the early morning hours. Single-dosing of prednisone is closer to his body's rhythms. That may be his MO's thinking. We often focus on the PSA when it his _total well-being_ that is the goal. If he has pain-free bone metastatic disease, that seems to me to be a good balance.
You seem to have specific knowledge of prednisone. My MO prescribed 2 5mg even though I was on Xtandi. (When questioned she said for fatigue.) I did get her to go down to 1 5mg and in April will suggest suspending it all together. (Been taking it for 2 years now.) Knowledgeable persons here wonder why I'm taking it at all (same as me). If I'm only taking one, and there is a morning burst of the adrenals, should I take the 1 dose in the evening? Exactly opposite of what I'm doing? I understand if you do not want to respond. Thanks. Monte
Shit, Why wouldn't anyone want to respond? You're a nice guy battling this dreadful disease. If I knew how to respond to your issue(s), I would. You could take that to the bank.
Take it in the morning to supplement what your body may be producing. I say "may" because when we take external adrenal steroids like prednisone, it tends to suppress natural production. Like others I am not sure why prednisone gets thrown into the mix. It tends to reduce the body's immunity mechanism. Hope that helps.
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Is it reasonable to pursue ultrasensitive PSA test that is more precise than undetectable at <0.05?
2 years into Stage 4 Treatment 
How many of you would pay $2200 for a 3 month supply of Zytiga?
Psa rise after 2 weeks on zytiga
Lupron and xygeva only
