Xtandi fail chemo next

[Blair77]

My husband is being taken off Xtandi though his PSA is low (3.7) they suspect his PC is not producing PSA. His ALP is 135 up from 95. Is there another marker to follow to measure progression. His ALP has risen over the last few months so maybe the ALP?

[Blair77]

Hi Nalkrats,

They did an additional biopsy on one of his bone lesions and it was determined not to be endocrine. Our UCSF doctor said they sent the tissue to Duke University to some Pathology guy who's an expert and reported no neuroendocrine cells. The doctor is calling it double negative PC. Have you heard of this? I saw an article recently about it becoming a new type of PC.

[CantChoose]

Alkaline phosphatase shows bone is being broken down, which is why a rising number there signals growing cancer. That, plus scans are what we have with conventional lab testing.

[Tall_Allen]

ALP, PAP, CTC... but radiographic may be his best indicator.

[MateoBeach in reply to Tall_Allen]

Ive been curious about circulating tumor cell counts as quantitative monitoring alternative to PSA. Do you have a reference on this T_A? Thx.

[Tall_Allen in reply to MateoBeach]

5 or more on CellSearch is associated with Mets.

[Fairwind]

A fresh bone scan that can be compared with an earlier scan would be informative..

[Hidden]

Imaging is the gold standard to determine progression. Blood tests are helpful, but often not specific enough. Rising ALP is a fairly good indication of progression although 135 is not out of normal range. ALP is also produced in the bones, liver, kidneys, gallbladder, and intestines so a more specific indication would be Bone Specific ALP. But again, determination of progression should be made with imaging, and I don't see why he should be changing treatment without that indication. Just my opinion.

[Blair77 in reply to Hidden]

They did an axium scan that looked pretty bad in May. However, one had never been done before so they had nothing to compare it to.

[Hidden in reply to Blair77]

Sounds like you said there has possibly been progression since then. If so, it would be a good to get another scan and compare. Are you having any new pain symptoms? How do you feel overall?

[Blair77 in reply to Hidden]

He’s not had new pain. I guess we will wait and see 😒

[Hidden]

Some good advice here. Keep up the Xtandi. Try to avoid "hard" chemo like Docetaxel because it can go very wrong very quickly. Like Russian Roulette, there is a live round in one of the 6 chambers. Have you tried intravenous Vitamin C? It is harmless to find out if it works, and could be a treatment turning point to an easier route and add a few more years.

[whatsinaname in reply to Hidden]

First time, I am hearing Docetaxel being equated with Russian Roulette with one live round in one of the six chambers Apt comparison. Kudos !!!

[CantChoose in reply to whatsinaname]

The bullet is just different. Immunosuppression vs. electrolyte imbalance. 1 in 9 either way.

[Hidden in reply to whatsinaname]

I get very little input from my team but the one thing they did answer was they don’t think chemo is helpful. Don’t ask me why but when I ask them if it would help me the answer was just that. Anyone else get that response?

[Hidden in reply to Hidden]

Where are you getting treatment?

[Hidden in reply to Hidden]

Md Anderson

[whatsinaname in reply to Hidden]

My quacks (MO's) in Bombay desperately want me to do chemo because they make a lot of money out of 6 cycles. In fact, even though its not working, they try to push for 12 cycles.

[Hidden in reply to whatsinaname]

I can’t tell you why mine don’t like it. Wish I knew.

[Hidden in reply to whatsinaname]

I got the bullet in Round 1, and like a fool I carried on ... and took another bullet in Round 4. Nothing like 2 near-death experiences to start asking questions like "What is wrong with this picture?" I am now a lot wiser. But you have to dig for the truth - it is not there in the mainstream literature. Its omission is deliberate which is the real shocker as "The Cancer Industry" presents a unified face with many false choices.

[whatsinaname in reply to Hidden]

What are the odds that Cabazitaxel would be the same ?? 80-90% or even higher ??

I have failed Docetaxel......so what do you think my quacks are "pushing" now ???

Why, Cabazitaxel, of course.

[Hidden in reply to whatsinaname]

Just about the same thing chemically! The upside to a $30,000 a month price tag is that millions of Indians get protected from the stuff by the price barrier. But the Docetaxel "commission" is presumably higher if that is offered first?

[whatsinaname in reply to Hidden]

Yes, indeed it is higher. Though, the generic Cabazitaxel is only marginally cheaper than the generic Docetaxel. Still, they force you to have the more expensive one first, just in case, you know

[larry_dammit]

I would think the doctor would order a set of scans to compare growth in the Mets. Alkaline levels can detect cancer growth or decay.

[Hidden]

Md Anderson