So, after my dad's increases in PSA over three month periods (.07, .13, .23) his oncologist suggested we start with Xtandi and sent us to see an oncologist at the Cleveland main campus regarding Provenge. Well, insurance decided that they weren't going to cover Xtandi and said it's Zytiga for you! So, we headed in that direction.
In the meantime, we went to see the Cleveland clinic oncologist (specializes in urological cancers) and we were surprised to hear that she doesn't agree that we need to move onto a new therapy at this point but rather should get updated scans (he hasn't had any since 2015) and then we should decide on a new therapy. She didn't seem overly excited about my dad's PSA increases at all.
She said if his scans don't show any disease progression than he'll be a perfect fit for Provenge and that afterwards we'll not move on to Zytiga or Xtandi but rather will stick with Lupron as she isn't convinced that he's failed it.
I was a bit surprised to hear that the upward movement didn't lead her to suggest another therapy, but I am pleased that she's set up new scans as it's been too long. He goes in on Thursday for the scans and we head back on Tuesday to Cleveland to see what our next steps are.
Thoughts?
(And to recap my dad's history, diagnosed in June 2015 PSA 257 mets to local pelvic lymph node. Had chemo and has remained on Lupron + Casodex until the end of September when he dropped the Casodex. He feels great and his labs look wonderful. Dad's 78 years young. =) )