Husband dx 7/2017 at age 48 Mets all over shoulders to pelvis and lymph. Taxotere with ADT. Good response. Psa in sept 2018 1.35 the. It went to 1.63 then to 2.11. Talked about Zytiga came back two weeks later for follow up Psa now it’s at 1.93. So basically trend up twice and now down a little. Anyone go through this? Perhaps we will see what next months looks like before trying the Zytiga?
Thoughts?
Do not wait on Zytega. Early use is better than later use. Way better in terms of living longer.
Schwah
There is also the AVR-7 blood test to determine whether he is respond well to Zytiga and Xandi or not. My SO saw Dr. Lam for a 2nd opinion while he was on Zytiga for about 2 months. Dr. Lam ordered the AVR-7 test. It takes about 2 weeks for result and is covered by medicare.
If you can get Zytiga now, why wait?
My fear is spending all our lines of treatment too soon. But if doctor says to do it then I don’t see why not but if his Psa trends down again wondering if it’s necessary now at this very moment
There will always be new treatments. Treatments now extend life more than treatments later.
I changed my outlook on treatment, I was diagnosed at age 57, now 63. When I was first diagnosed my medical team and I would thing in terms of 10-15 years when making treatment decisions, that resulted in a lot of unnecessary stress about making a decision and in one situation, making a poor decision about which treatment to do. Gradually I changed to ask, will this work for the next 3-5 years, if so, let's do this. That allows me to enjoy that time and allows for new treatments to come into play for the next decision time
We you dx stage 4 from the start? I totally get what you are saying. Unfortunately from what I have read, it appears that everyone responds to treatment differently. It’s hard to gauge how you will respond. When I my husband was dx he was 48 with Mets from shoulders down. And they noted some neuroendocrine differentiations. Went to see Dr Beltran and they decided it wasn’t too apparent so we treated him like classical/adenocarcinoma. All in all I understand the thought process of doing it now than later, which is why we did the chemo upfront.
I was diagnosed in Jan 14, PSA 2.1, DRE positive, TRUS biopsy indicated GS9. Had surgery in Mar 14, T2CNoMx, GS 8, margins, seminal vesicles and ECE negative. Had SRT in Mar 16 after PSA rose to .3, completed those 39 treatments in May, labs 90 days after that showed PSA now .7! 30 days after that 1.0...My PSADT and PSAV velocity indicated I needed to do something quickly. So in Jan 17 I went to Mayo where the C11 Choline scan showed four pelvic lymph nodes with PCa and fortuntaley no bone or visceral involvement (PSA was 3.8). We agreed to a combined therapy of 18 months of ADT, six cycles of taxotere and 25 more radiation treatments. I finished that in May 18. Labs since then:
AUG 18 PSA <.1 T <3
Oct 18 PSA <.1 T 135
2 Feb 19 PSA .36 T 481
16 Feb 19 PSA .24
2 Apr 19 PSA .06
So, I am high risk, GS 8, BCR only 18 months after a very successful surgery, the failure of SRT, PSADT and PSAV. I have tried three times now for the elusive "cure." That is not going to happen so I and my medical team now approach my health from a chronic disease aspect or as we call it, the whack a mole plan. If my PCa returns as evidence by a continuous rise over time in my PSA then we will image at a PSA of 2.0 using the Aximun scan and with that data (assuming it identifies where the recurrence is), we will develop a treatment plan, combining system and local treatment. My radiologist is prepared to deliver stereotactic spot radiation, my urologist is prepared to put me on Lupron and Zytiga, we agreed that it would be for a defined period and if I get a positive response then stop treatment at some point, most likely 12 months and actively monitor.
So, we have a plan to monitor, gain clinical data, treat, monitor...
Again, this is in the context of 3-5 years, not 10-15.
Kevin
Your husband's journey - diagnosis, age, presentation, PSA drift - are similar to mine. Listen to the experts here - if you can get Zytiga now, get Zytiga. There is only appropriate treatment now; there is no saving the fight for a different day. Also, as Bill68 says, look into Provenge now (most insurance providers will not approve if already on Zytiga and responsive) - this is not a direct treatment that will affect PSA, but it is proven to lengthen lifespan.
MO didn’t discuss that. But I can certainly ask. It seems everyone has a different position on how to take Zytiga. We will be doing 250mg with low fat food. Others take 1000 a day without food. He said studies have shown it has the same efficacy without the other side effects
That's not correct- side effects should be exactly the same either way. Fat increases the absorbed abiraterone dose, so theoretically (sample sizes were small and individual results vary), 250 mg with a high fat meal should get exactly the same amount of abiraterone into the body as 1000 mg taken without food. The only reason to take with food is to save money.
Agree. Start Abiraterone. Do you see an oncologist who specializes in pca? If not you should
We do at the university of Chicago he is the chairman of GU
Looks like most say don't wait. Consider Tall_Allen's comments very carefully. Listen to doctor. I went from chemo to Xtandi. After 2 years psa is 0.1.
Tall_Allen know his shit... follow his advice...
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 04/19/2019 6:15 PM DST
Hi guys just wanted to give you an update. It’s been a little over a month in which we’ve started Zytiga and his PSA is the lowest it’s been since dx 1.0. Thank you all for the support! The only thing that we’ve noticed is the effects from HT have been a bit harder, more crying/depression but he’s been fighting it with the Medical Marijuana. He just completed his first triathlon for the year and came in 4th place in his age group (50). All bone Mets are stable (he lit up like a Xmas tree at dx)
We fight on!
Zytiga and PSA
Has anyone experienced a significant decrease in PSA on Zytiga and then an increase 
Slow rising PSA. Wait and watch?
PSA dropped again💙
