I'm on Lupron/Zytiga and am wonderfully covered by my company insurance - but i'm planning on retiring the first of next year and need to transfer to medicare that isn't so wonderful.
I've had IMRT in December/Jan - and have been on Lupron since October - i added Zytiga in March because i wanted to be as aggressive as possible in my initial treatment - and my PSA is nd.
the cost of zytiga under medicare is pretty steep - so my plan is to
1 - go to the generic at my next dr appt (Sept)
2- look at going from 1000mg/day to the 250 plus yogurt - i have the articles and am going to send them to my MO before my appt to get his take.
3 - i plan to switch to medicare in march so i only need to worry about March (maybe april depending on when i get my last prescription) thru October (8 months)
So my question is how many have gone to the 250 mg/day+yogurt - and has anyone had to go back to the 1000. Is your MO supportive?
Also i'm on 2x5mg of prednisone - i see people mention going down to 2x2.5 mg (5mg total per day) - i would also like to look at that - not because of cost - but just trying the reduce my overall drug consumption (also on BP and statins). What are your experiences - has anyone ever had to go back to 10mg/day - and why.
I'm doing well - just the normal side effects, but i'm trying to get more sleep and hitting the gym hard at least 4 times a week for an hour of cardio - with 15 minutes of heart rate in my peak zone (according to fitbit).
any advice would be greatly appreciated.
Paul
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PabloK
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I have - but i need to go back and check again because our medicare lady thought my lupron was under part D - but my doc says he bills under Part B - so that will change things - and i don't think any of the programs include the generic at this point - she said that they will be able to see the new programs in October - so that will give me plenty of time to make a decision
Your doc is correct, Lupron bills under traditional Medicare part B. However some part D programs also cover and/or pickup the co-pay for Lupron. Good luck!
A typical co pay with Medicare part D once you have paid the donut hole portion is about 150 per month for generic Abiraterone. Why not check with the physician prescribing it before you make any changes?
I can give my thoughts on prednisone. I also didn't want more drugs and more side effects, but it turns out prednisone also had activity against the cancer. There was a recent link to a study that showed longer overall survival with 2x5mg a day than 1x5mg, which in turn was better than 2x2.5mg if I recall correctly. Dexamethasone 1x0.5mg was better than all prednisone groups.
Your statin also has anti cancer activity. I'm also off the opinion that getting your heart up near is peak regularly also fights cancer, but only have indirect evidence to back that up.
With all that going for you, you should have a long and healthy retirement!
thanks Tom - wrt the exercise, i watched a video from UCal system that someone referenced a month or so ago - and the Doc presented the results of a study that did show improved results with increasing levels of exercise - and to be honest, it makes me feel like I'm fighting back - so i have decided to believe it does make a difference.
and btw - you have convinced me to stay on the 2X5 prednisone.
Though I haven't had time to read it all yet, the summary is very promising:
"Exercise is one of several lifestyle factors known to lower the risk of developing cancer and is associated with lower relapse rates and better survival. This review highlights the numerous biochemical processes, which explain these potential anticancer benefits."
Table 1 is particularly interesting, as it lists specific effects of exercise such as reducing inflammation, increasing immune activity, and reducing growth hormone levels (which I've read elsewhere is related to the normal cells becoming more sensitive to and thus requiring lower levels of growth hormone, insulin, etc.)
You should probably wait til later in the year to check on the new medicare formulas when they come out. I am hopeful with all the generic abiraterone that Part D costs will come down for next year.
On a monthly shot of Firmagon and daily taking Zurich’s and prednisone. While recently diagnosed and on this regimen for only four months, I have taken 250mg of Zytiga with low fat breakfast along with 5 mg of prednisone. To date PDA dropping- now .91- with minimum side effects. Cost about $500/month with expected reduction after donut hole.
You're 67 now.... If you like (enjoy) your job... don't retire.... If you wish to retire wait until the middle of 2020 and see how you feel and etc. Good Insurance is worth its weight in gold (literally).
I think the 'toxic finances' scared me more than the cancer.
Start to learn about the lesser-known Medicare plans, Plan F and Plan G. (I think F will be discontinued.) First dollar total coverage.
You have to pay a premium - mine is about $350 /month. It's a real bite out of my Social Security check, but way less than the cost of cancer treatment.
I'm not bankrupting my family treating a disease that's terminal anyway.
My MO told me that taking one 250mg tablet of Zitiga with a low fat meal has been shown to be very effective, with one 5mg predisone tablet twice a day . I just started 10 days ago. However, I'm probably not a good test case since Xtandi stopped working for me, I'm told that there is less than a 20% chance of Zitiga being effective.
I've been on 500 mgs for two years -- first Zytiga and now aberaterone -- and am sailing along happily with psa undetectable. Larger doses scrambled my liver readings. MO said the 1000 mg dose stemmed from the trials, there was no firm logic behind it.
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Starting Zytiga / Prednisone Regimen
Liver problems with Zytiga 
Zytiga dosage
Reducing zytiga dose
Zytiga with/without food ?
