Today's "Report Card" 2 mos. into Zytiga/Pred added to Lupron

[spouse21]

My husband and I saw Dr. Matthew Smith at Mass General today. Everyone's satisfied with the trend: the 1.8 PSA today dropped down from 4.08 on 2/28/19. This is nine weeks after Zytiga/Prednisone was added to Lupron on 2/9/2019. I recently added Alkaline Phostaphase data to the signature below. Here's a link someone posted awhile back about positive prognosticators on Lupron/Zytiga/Prednisone:

ncbi.nlm.nih.gov/pubmed/269...

It's good if PSA goes down by half at 12 weeks and ALP bounces a bit. My husband is only at 9 weeks but he's easily down by half on PSA since Zytiga initiation, and the ALP went up then down. Hope that's not too fast, but we'll take it for now but maybe others can read the tea leaves better than I can.

Here's his signature with the updates.

Husband 70 yrs (74 now) pacemaker; Agent Orange 9/14: blood in urine; DRE suspicious 11/14: biopsy G 9 (4+5), PSA: 3.32 high Gleason, low PSA, PNI involved

Lupron taken for 33 mos (currently on Lupron again after a year hiatus.)

6/15: 9 wks IMRT

9/15= .14

1/16= .093

4/16= .079

11/16=.05 (nadir)

2/17-5/17=.05

1/18=.08

2/18=.20

4/18=0.98

6/18= 3-4 bone mets seen on CT scan

7/18= 3.29 (ALP 73)

8/28= 9.0 Lupron re-started with a month of Casodex

11/27/18=7.0

2/9/19 Zytiga/Prednisone started with ongoing Lupron

2/28/19=4.02 (ALP 85)

4/11/19=1.80 (ALP 68)

[tallguy2]

Your husband's response to Zytiga is encouraging. Best wishes, and thanks for posting! If he develops bone pain there are options.

[6357axbz]

Agree with tall guy, if/when I add Zytiga/Pred to lupron it will be well beyond the normal time for doing so. I am about to begin IMRT about the same time after my Dx as did your husband. I’d love to get a 33 month run on lupron alone!

[Schwah in reply to 6357axbz]

That’s your choice. But FYI, two clinical studies showed overall survival improved overall survival by some 40% for men who used both Zytega prednisone and lupron early vs those that did lupron alone. Many prostate oncologists called it the single biggest change in treatment of metastatic PC in 50 years.

Schwah

[6357axbz in reply to Schwah]

It was not my choice to delay Zytiga/Pred. I questioned my MO about why I was not given this and he thought the toxicity, for me, was a risk. I have coronary artery disease and a poor family history (father, brother and paternal grandfather all died from heart attacks). I’ll be seeing him again on Monday and will question him further. My RT told me he also questioned my MO about this and was told that not taking it now keeps me eligible for more clinical trials for when I become CR. I have a lot to discuss with my MO on Monday.

Thanks for responding Schwah.

[Schwah in reply to 6357axbz]

In the end you will need to obviously decide which risk is bigger. Waiting or starting Zytega now. I pray you will make the right decision. If it were me I’d probably start the Zytega now and monitor it closely. Perhaps at a lower dose.

Schwah

[6357axbz in reply to Schwah]

Good advice Schwah. Thank-you.

[6357axbz in reply to Schwah]

Of course there is the fact I have only two mets, thankfully, and there seems to be less evidence that early Z/P helps in “Oglios”

[j-o-h-n]

A Husband who is 74 years old with a Spouse who is 21. What a lucky guy.

p.s. Thank him (and me too) for his Service to the US government, voluntary or compulsory. Good Signs...

Good Luck, Good Health and Good Humor.

J-o-h-n Saturday 04/13/2019 7:36 PM DST

[spouse21]

Ha! J--o-h-n. I picked that number out of the air. I haven't been 21 since the last century. Thanks for your thoughts, and same to you.