All has failed inc Zytiga sud try chemo as last resort

[G2779]

My father has had prostate cancer spread bones last 5yrs tried lu177 , psa was 33 in July when got first lu177, then doubled Aug, on Zytiga psa when up then dwn 50, backup again 90, is there any hope left , lreland so doctors don’t give us many option only chemo , what do think is it end , plus vry sick vomiting

[Magnus1964]

How old is your father, what is his weight and what is his general health? These will determine how well he would tolerate chemo. If he cannot tolerate chemo he can still get some years out of ADT drugs.

[G2779 in reply to Magnus1964]

Hi magnus1964

He’s 73 had triple by pass 20 yrs ago , doc tell there nothing else only chemo , he’s been on firmagon and now 3monthly Decapeptyl , what other ADT do you think , here in Ireland we don’t have many options on treatment with hse due cut backs 🙊 they say .. is psa risen since July it’s now over 90

[Magnus1964 in reply to G2779]

Lupron is usually the first drug given. if and when it fails you could move on to casodex, zytiga or xtandi.

[G2779]

Hi nalakrats for you reply , I’ll talk again with doc , hear very different doc not overly helpful think at age over 70 ur ready for death 🙈terrible system here

[Tall_Allen]

I think chemo should be one of the first therapies instead of "the last resort."

[G2779 in reply to Tall_Allen]

Really tall_allen

Just dr Baum at bad Berka germany told us never take chemo ? Not sure now what to think , is there any particular type or name of a chemo which is best do u think

[Tall_Allen in reply to G2779]

The only kind of chemo used for normal prostate cancer are taxanes - docetaxel or cabazitaxel. In the CHAARTED trial, early use of docetaxel increased survival (and quality of life) by 1 1/2 years. When it's been used as a last resort, the survival increase is only a few months and side effects are worse.

[whatsinaname in reply to G2779]

Why not just follow Dr Baum of Bad Berka ??

Especially, if Lu-177 + Ac225 has worked for you.

[tango65]

Chemo could be a good choice if zytiga is failing. Adding chemo after failure of zytiga or enzalutamide may be better than trying other anti androgen.

ncbi.nlm.nih.gov/pubmed/302...

Niclosamide could resensitize the cancer to enzalutamide or abiraterone. The problem is , niclosamide is not absorbed in the gut in such amount to get a therapeutic level in blood. The people at Davis , California are recruiting patients for clinical trials with modified niclosamide which is absorbed in the gut:

clinicaltrials.gov/ct2/resu...

[pcfred]

I'm 70, been through most of the medications and clinical trials, now on chemo (docetaxel), it's been working. Before starting chemo the cancer was attacking my bones pretty good, lots of pain. After the first infusion the pain went away and I felt much better besides the side effects of chemo. I hate chemo, 3 to 4 days after infusion the side effects start, food taste horrible, fatigue, I sleep a lot and feel generally like crap for the next week and a half. I do have a couple good days in between. I'm sooo tired of it but it's working so I have no better choice.

[Hurling24]

Hi, I'm in Ireland too.

Where did you get LU177 ? its not available in Ireland. As for options we have exactly the same as the USA and at little or no cost. maybe you should get a second opinion. As for gene mapping you can have tha done in Dublin. PARP Inhibitors are available in a number of trials again ask your Doctor. Chemo is usully the first line of treatment following ADT and the third line. Please message me if you want details . Slán

[G2779 in reply to Hurling24]

Hi

Yes I took my father to bad Berka Germany for lu177 , but now his psa risen fast he’s not able to go back , I’m looking maybe for somewhere closer maybe private hospital dublin? Do you know of any good doctors who mite c him

Thank u Grainne

[Hurling24 in reply to G2779]

We are in Cork under the Bon Secour Hospital. Have you tried the Bon Secour Dublin?

[dadzone43]

It is a "Sophiexs Choice" situation, isn't it. There is always hope ,but there is a.so reality. What does your dad want? I am a bit older than he and if faced with the choice between a few more months with chemo and its side effects and palliative care with good pain control, I reckon I'd take the latter. It may seem harsh, but the miseries of late-stage chemo are harsh also. I wish you both the best. "Go not gentle into that dark night: rage, rage against the dying of the light."

[G2779 in reply to dadzone43]

Hi

He wants to fight on , I know what ur saying about chemo , but he’s even sick at moment without ..

[dadzone43]

So tough. SO sorry for you both. If he wants to fight on, if he is mentally competent to make that decision, then you both do the best you can facing a wall of really hard choices and no "right" one. I treasure your response just as he must treasure your love and concern. I may find myself in the same crosshairs one day.

[Amandaking]

Lu177 is available privately in England at The London Clinic and at Genesis healthcare in Windsor.

It doesn’t work for everyone- my husband had 2 infusions and his PSA went up and scans showed progression even though he was PSMA avid.

Good luck