Need input from members

[Racer26]

9/13/18 PET scan showed metastasis 3 spots on pelvis (Had proton in 2011) Been on Lupron then allegard last couple of years 8/11/18 started with an oncologist(Northwestern Cancer in Warrenville Il) and he stopped meds( Casadex ) until psa went to 4.8 to do pet scan 9/13/18 then started me on Zytiga and prednisone and a 6month shot of allegard, 1/8/19 psa 0.85 testos 8 2/4/19 psa1.94 2/25/19 psa2.27 test 10 and now 4/2/10 2.61 test 10 Am in Fl. and going to Moffitt in Tampa for 2nd opion, could you give me some opion on whats happening and some questins to ask new oncologist. Thank you you guys are great!!

[Tall_Allen]

Have you considered Xofigo? You might switch to dexamethasone from prednisone - it may prolong your time on Zytiga.

[Racer26 in reply to Tall_Allen]

Allen do you think the zytiga is failing

[Tall_Allen in reply to Racer26]

Your PSA is rising on it, but your oncologist will also want to see if your mets are growing. Dexamethasone may be able to give you extra time on Zytiga.

[Racer26 in reply to Tall_Allen]

Thank you very much

[tango65 in reply to Racer26]

The cancer is becoming castration resistant. PSA increasing with castration levels of testosterone. You could discuss with your doctor to do Provenge and Xofigo. Eventually you could also discuss to have a PSMA PET/CT and if it shows metastases you could consider to get treatment with Lu 177 PSMA or AC225 PSMA. This could delay the use of the new anti androgens and chemo. Xofigo can not be done if you are taking Zytiga or if there are visceral metastases.

[Racer26 in reply to tango65]

Thank you tango65 you are a great help

[johnscats in reply to Tall_Allen]

hi tall allen diagnosed with stage 4 prostrate cancer with mets to l4 t5 pelvis 2lmphnodes femour bottom of right lung left lower rib that was in december 2017 febuary psa went from original 464 to 55 they then added zytiga unfortunatly have a bad allergy to it and had to be discontinued rso oil then given with 4 MU 25th of july 18 ct scan with contrast prostrate 2mm smaller than a normal one lmphnodes normal lung tumor undetectable reduction in met sizes allround 16th jan 2019 ct scan with contrast there not sure now whether mets are scar tissue or stabelized bloods normal scince august 2018 my psa was 2.16 it then increased to 3.8 slowly then blood test 23rd of march 2019 psa has dropped to 2.19 not sure what all this means i would like to know what all this means cancer is gone or cant be seen not getting much info from onc going to see another one on thursday best wishes everyone j

[Racer26]

I had hoped Zytiga was going to give a couple of extra years Thanks for the reply

[NPfisherman]

I agree with Tall Allen on the switch to dexamethasone....you may try adding indomethacin also to break resistance:

ncbi.nlm.nih.gov/pubmed/277...

mct.aacrjournals.org/conten...

Great if you can ride the Zytiga train for a while longer...squeeze the most out of the drugs is my motto...... Good luck....

Fish

[Racer26 in reply to NPfisherman]

Went to Moffitt cancer center in Tampa Fl Met with Dr Hwang and his medical assistant which were two off most educated Doctors I have talked to. My wife said she was very impressed with knowledge I had about the prostate meds and I owe that to everyone on this forum. Dr Hwang agreed on the dexamethasone and gave me a prescription to try. Will keep you updated. Thank you

[NPfisherman in reply to Racer26]

May it get your PSA headed down again...there is a phase 2 trial for enzalutamide and Indomethacin for breaking resistance and there seems to be some cross resistance when people have been on abiraterone , get resistance, and then try to switch to enzalutamide and it doesn't work either... There have been a couple of articles on Zytiga and indomethacin but it will never see a phase 2 trial after going generic...one below:

sciencedirect.com/science/a...

Keep the indomethacin up your sleeve to pull out if needed is what I would do... Your PCP could even put you on it...

Good luck,

Fish

[Racer26 in reply to NPfisherman]

thanks for the info I am savings it. I also booked a bucket list fishing trip to Manitoba with my brother ,son and daughter. I hope I can do these for about 4 more years. Thanks again

[tallguy2]

I had a similar situation last fall. Three areas of metastasis. Also, I had "No circulating tumor cells" per a very expensive blood test ordered by my oncologist. Given these data, I chose EBRT for not just the three areas identified by PET but also adjacent areas per the recommendation of my RO. NOTE: there is NO evidence of any long-term benefit of this aggressive approach, but two of my oncologists suggested it, my urologist was indifferent, & my insurance approved it.

[Racer26]

Hope it works and it will be a peace of mind also

[elvismlv123]

I cant tell if you are hormone sensitive or insensitive....It looks like they are trying not to allow to become hormone insensitive. Withdrawing hormones should prevent lesions.