I am on Zytiga and lupron for the last 17mos. Previously rad prost, radiation. Gleason 9 3 cores no lymf involvement 4+5. Clear margins. Current day PSA has risen 6 consecutive months. Now 2.06 3 weeks ago 1.51.
I recently got a 2nd opinion from my oncologist. A well respected prostate cancer guru. His take was to stop taking zytiga increase lupron dosage because I am a larger guy. Start xtandi in three weeks he also stated the pet scan has little value for now. In favor of bone and cat scans. I am very concerned about the Mets going from micro to attaching in a macro way, The last scans in July and April respectively showed nothing visable. I suggested the new drug nubequa as tall Allen . Recommended. My testosterone is 3. Am I on the right track. Is this a reasonable next step .
Thankyou all.
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Costarica1961
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If you're interested in getting a better picture of the mets, why don't you opt for a PSMA scan (if financially feasible). I'm not entirely sure if you are castrate resistant yet, but if determined so, there are several trials you can sign up for. If not eligible for trials (and again, financially feasible), you may want to discuss the possibility of LU177/AC225 treatments overseas with your MO. There are some (light) evidence that these treatments seem to work better the fewer pre-treatments you get.
I agree although my insurance denied a pet scan. As well the D.r said it often confuses the issue and he did not see the value in it.not very familiar with the overseas option but I will look in to it
"As well the Dr. said it often confuses the issue and he did not see the value in it."
A well respected doctor who gets confused??????? Hmmmm ya think he's taking too many confusion pills or he can't be bothered fighting the insurance company for you?
Seems you are on the right track. If you add a weekly Sodium Ascorbate IV to the Xtandi, you can cut the dose right back so side effects effectively do not apply. Then take a look at the mets as they should calm down when your PSA goes back down closer to the 0.1 mark.
It would be nice if someone would test if the same kill mechanism works with Nubequa (which is supposed to be similar to Xtandi in the way it works). You have the luxury of some time to experiment to find minimal dosages and see if a gentle solution will keep you going a few more years with a normal quality of life. A low PSA means your immune system is dealing with the mets and will put them out of action with time and a good diet. Good luck!
Going by first principles, I would definitely go the PET PSMA scan way and see what is really there; PSA doesn't tell us that much. Then follow up with Lu177 if PSMA avid. Hit the PC from another angle and then come back to androgen receptor antagonists later. =Rob
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