Been on zytiga for a little over a year. PSA rose from undetectable to 2.26 on oct 14. On oct 24 I had an appt with dr and he said to come back today ( oct 31) to discuss next treatment option ( Provenge, xofigo, Xtandi or PROSTAR trial using Xtandi) He did recheck my PSA on the oct 24 appt
So , backing up a little .... when I got my results from the PSA text on October 14 that shot up from 0.99 to 2.26 I switched from prednisone to dexamethasone. The PSA after that , 10 days later was 1.84. So is this significant?? Do I ditch zytiga or give it a little more time with dexamethasone? Could I do Provenge with zytiga??? I want to do all I can to beat back this cancer, but at the same time I want to get as much use out of each treatment as I can before giving up on it.
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Peterd110
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It has the same degree of side effects as abiraterone when used early (although different in kind). The idea of "saving for later" has no basis in medical evidence.
Been on Zytiga, Prednisone , Xgeva for 21 months PSA 0.1 from start of treatments. I was administered Provenge in late June never stopped Zytiga before, during, or after Provenge infusions. So far so good and still undetectable. I guess it's ultimately the medical professionals decision as to the outcome of treatment and the patient individual Cancer. Never give up never surrender. Leo
Most of what I learned about Provenge is that it's effectiveness is minimal--extending life 3 to 6 months. Is it worth the cost? Well, of course we can't put a dollar amount on our lives, but at some point we have to weigh the advantages against the disadvantages and, for me at least, it wasn't worth it.
I realize this thread is a few months old...but this recent study showed significant benefit when Provenge was added to Xtandi or Zytiga:
ASCO GU: Real World Study Finds Adding Immunotherapy Reduces Death by 45% in Advanced Prostate Cancer
San Francisco, CA (UroToday.com) -- Dendreon Pharmaceuticals, a commercial-stage biopharmaceutical company and pioneer in the development of immunotherapy, released results of a first-of-its-kind study examining survival outcomes in men with metastatic castrate-resistant prostate cancer (mCRPC) who were treated with PROVENGE® (sipuleucel-T) and oral agents in a real-world treatment setting.
According to a retrospective analysis of medical and pharmacy claims data from more than 6,000 Medicare Fee for Service beneficiaries, the addition of PROVENGE to either Zytiga® (abiraterone acetate) or Xtandi® (enzalutamide), at any point in a patient’s mCRPC treatment regimen, reduced the risk of death by 45% and extended median overall survival (OS) by 14.5 months.1 These findings were presented in a poster session at the 2020 ASCO Genitourinary (GU) Cancers Symposium in San Francisco (abstract #42, Poster Session A, 11:30 a.m. PST).
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with drawl side effects or new side effects 
PSA drop after Provenge.
Zytiga to Xtandi
Provenge immunotherapy
