Still undetectable

[Mkeman]

In August of 2017 I was diagnosed with Stage 4, Gleason 9 with Mets in right hip, right shoulder and L3 vertebrae. Was started on Trelstar after short course of Casodex. In January of 2018 MO added Zytiga and prednisone and switched from Trelstar to Eligard.(cost less).Have had undetectable PSA

since....including test yesterday. My regimen is to take four 250 mg of Zytiga at 8 am followed by by an hour of fasting. I take 2.5 mg of prednisone twice a day. I asked about the suggestions that you take less Zytiga but with food. She said that there is insufficient data available to prove that any protocol other than the one I am on will deliver the correct

therapeutic dose. I mention this because there have been a lot of mentions on this site of patients taking Zytiga with ice cream or eggs

or other food. If you are one of them I would encourage you to first get the blessing of your MO. The cost issue is still there, but is less with the advent of generic abi. The price has dropped from $12000 per month to $3400. If you go to Goodrx.com you can find the price in your area.

[AlanMeyer]

Hello Mkemon,

I have attached a link to a study of 72 men randomly assigned either to take the full 1,000 mg dose on an empty stomach or a 250 mg dose with food. 34 men in each group completed the study (2 dropped out of each group.) Surprisingly, the men with the lower dose actually had a better response to the drug than the ones with the higher dose.

I believe that your doctor is right that the evidence is insufficient to prove that the lower dose is as good. The sample size is too small to assure us that the results are not due to random factors. However, the study does at least provide some evidence of both safety and effectiveness.

If it were me, I think I'd be really, really tempted to go for the 1/4th dose. Even at $3,400/month for the generic, the savings would be $30,600 over one year. For anyone taking the brand name drug at $12,000/month, the savings would be $108,000 over one year.

Here's the link:

ascopubs.org/doi/full/10.12...

Alan

[Mkeman in reply to AlanMeyer]

Thanks. You are right. But my MO is very conservative and wants to see larger study before she actually directs a patient to do it. Part of problem is what food and how much and can you eat consistent quantities every day. She also points out that money for studies Is hard to come by since there is no incentive for drug companies to recommend fewer pills.

[NPfisherman]

Congratulations on your excellent results....Keep fighting, brother....

Don Pescado

[Mkeman in reply to NPfisherman]

I will. Thanks, Don.

[tango65]

Congratulations. Best of luck!!!

[Mkeman in reply to tango65]

Thanks. You, too.

[Hidden]

I wonder if a dr would even prescribe it if he knew what you were going to do with it. There’s a dr. In Chicago that promotes it. Mine would not do it.