My Dad had his prostate removed 10 years ago. After he recovered from surgery, he had radiation to the area for 6 weeks. ADT shots ONLY from 2010 until 1/2019. Now dx is CRPca, he began Xgeva, Xtandi(stopped as of yesterday 6/3/19) and Lupron in 1/2019. After 5 1/2 months on Xtandi, results from Xtandi are basically: More bone mets, lymph nodes have shrunk, Alk Phos has dropped significantly but PSA came down to 100 but has risen the last 2 months (in 300's now). Yesterday, MO has suggested 6-10 rounds of chemo/prednisone starting 6/20/19 at every 3 weeks, since my Dad is "healthy".
My question: has anyone here, AFTER taking Xtandi, gotten better results with Chemo or another type treatment and for how long? My Dad's real question is, is Chemo worth going through?
Thank you All! Kimberly
** note:LU-177 is not available for my Dad currently..its only available through clinical trial after Chemo. MO also mentioned Xofigo for later down the road. My Dad still works full-time in AutoPaint and Auto Body repair. He is 76 years old.
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savingdaddy
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Have a visit in a few days for my Lupron - 3 monthly, Zometa and consult. Want to ask about chemo, it's been a year so far with ADT/Zytiga, PSA 0.2...
Since clinical trials did not find difference with Chemo vs Abiraterone for overall survival, adding Chemo is not Standard of Care (SOC), which Dana-Farber sticks too...
I don't want to put words int TA's mouth, but I think he means that people keep pushing it off until it gets really bad. As in people have a super high PSA and are already at the end of their journey, when they finally do decide to get the chemo. That people like to keep the chemo in their back pocket.
Anyway. I saw some of your pictures on your trip with your wife and I hope everything is continuing to go well. I'm glad your PSA is at 0.2.
I was referring to getting chemo shortly after PCa stage 4 metastasis diagnosis, even if ADT is working. The idea is to hit all cancers early, with all weapons. I'm not comfortable waiting around for the inevitable castrate resistance to settle in.
So, there's docs that promote early chemo, had a consultation with Compassionate Oncology (Dr Bob and staff), they are critical with standard of care (SOC), which is the rule for Ivy-league docs.
Anyway, hey. appreciate your notice, the trip was timely, was falling into depression, then snapped out of it because of the time.
Last time I remember, your dad is doing well, awesome...
"Early" means newly diagnosed with multiple mets, or as soon as metastatic and castration resistant.
Docetaxel+ADT is certainly standard-of-care according to NCCN (which DF belongs to). Zytiga and Docetaxel were equivalent in overall survival and equivalent in the degree of side effects for newly diagnosed men. If one starts with docetaxel, one can get both docetaxel and zytiga in less time and earlier.
My husband is starting docetaxel in a few weeks. We've heard the side effects are more tolerable than many other types of chemo.
I wanted to say as well though that I was once in your shoes with my own father (lung cancer). I did all the research, asked all the questions, pushed all the treatments. And then he died, and I think it was harder on me because I truly thought I could change the outcome.
Cancer is a nasty beast. Do what you can, listen to his wishes and be there for him. But don't try to take it all on your own shoulders. ♡
To savingdaddy, Cancer is nasty but so is chemo , and chemo Is sometimes absolutely essential to kill cancer. I am alive today and in the 1 of 10 Lung Cancer Stage IIIB survivors in good measure due to two and a half years chemo along with maximum radiation and a surgical lobectomy. For my prostate cancer , I have recently completed IMRT and 6 months FIrmagon ADT. If chemotherapy is required in the future for my prostate cancer I will go forward with it without reservation. All & Only Best Wishes to You & your Dad, judg69
I apologize for not offering any suggestions nor advice, as the questions you ask are beyond my knowledge. However- I just wanted to applaud your father for continuing to work at his age while having to deal with his PC. Kudos to him and to you for looking for help on his behalf.
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Best wishes, Kimberly
What to do now?
What comes after, what comes next? 
Follow up on Zytiga 4 1/2 weeks later
Good news from my side as well !!
