Best new drugs for castrate-resistant PC?

[yeatz]

From Yeatz:

Last spring, had recurrence of high-risk PC after radiation & ADT 3-5 years ago.

Back on Eligard; PSA went from 2.7 to 1.4, then 1.7. But in past six weeks,

PSA shot from 1.7 to 2.8 with no testosterone; I assume it's now castrate-resistant (no mets). Unfortunately, PC went outside capsule, so curative treatments like HIFU, cryotherapy, etc. won't work.

I'm looking at new drugs; most-mentioned are abiraterone, enzalutamide,

and apalutamide (while continuing ADT) -- or some combination. I'd much

appreciate advice from those who have tried these. Or maybe I should try

one of the others mentioned in your Posts?

Many thanks,

Yeatz

[Tall_Allen]

If no metastases have yet been detected you can get Darolutamide (Nubeqa) which may be less fatiguing than the other second-line hormonals.

[Fairwind]

If you have not had SRT (salvage radiation treatment) that may STILL be curative if scans show no mets.. Not sure, maybe you can get Zytiga (abiraterone) now without any detectable mets..

[tango65]

I am also becoming castration resistant. No metastases according to a Ga 68 PSMA PET/CT done last January. The plan is to continue ADT and do another Ga 68 PSMA PET/CT to determine if there are metastases.

If there were few metastases they will try to treat them directly with SBRT. If there are many, I will try to get treatment with Lu 177 PSMA abroad. It is not the standard of care but it could delay the use of the new drugs, chemo and xofigo, the last defenses for the control of the cancer progression.

ascopost.com/news/september...

[Lt036]

Good morning yeatz. I am also castrate resistance have been on and off Lupron for five years till it stopped working now on enzalutamide (Xtandi) along with Lupron. Seems to be working but am suffering with extreme fatigue weakness loss of balance mood swings. Also double the amount of hot flashes, which I can put up with.

Other than that Xtandi is doing ok right now. Think the only side effects I am not getting is lossof weight which I could use. If you use it you may not have as much trouble as I. Lot do some do not. Either way you go good luck. I have been fighting this stuff for 21 years

Just now getting worse so hang in there.

[j-o-h-n in reply to Lt036]

Loss of Balance club theme song.... I'm a dues paying member...

youtube.com/watch?v=DndK5hZ...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/23/2019 1:23 PM EST

[Lt036 in reply to j-o-h-n]

Afternoon Mr j-o-h-n. Going to be on the poster for Help I’ve fallen and can’t get up.

[j-o-h-n in reply to Lt036]

LOL.... do we get two for the price of one on ambulance calls?

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/23/2019 11:12 PM EST

[monte1111 in reply to j-o-h-n]

Good lord. That was before they invented the science of acoustics. Now if you lose your balance and fall on Dolly....Parton you'll just bounce right back up.

[j-o-h-n in reply to monte1111]

Acoustics? Use sea shells............ I'd like to fall on her pink queen Conch slit.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/25/2019 5:07 PM EST

[monte1111 in reply to j-o-h-n]

That's how you roll. Can't just be a Conch. Has to be a queen Conch. I had plastic surgery done to my Dolly ....... it looks just like the original. Thanks to Amazon it says "Hello, I'm Dolly." What a rush.

[j-o-h-n in reply to monte1111]

You're soooooooo lucky, mine says:

youtube.com/watch?v=Dug-G9x...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/25/2019 5:35 PM EST

[Drphil1938 in reply to j-o-h-n]

You know why they give us old men viagra in the nursing home. To keep us from rollin out of bed.🍸🍸🤠

[j-o-h-n in reply to Drphil1938]

I know what you mean..... before Pca.... my nickname was "kickstand".... Now I'm more like doorstop....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/25/2019 5:38 PM EST

[luvhealth]

My husband has been on Firmagon then had to add Xtandi. After a year he has now gone totally resistant and his cancer is now more aggressive. PSA is very high and climbing and he has bone mets. We learned that the NSAID Indomethacin can revitalize Xtandi and we got a prescription and he is currently taking it, also helps with bone pain. He tried it several weeks ago for a few days and we saw a drop of 130 points in his PSA. Waiting for the next blood next in a week after getting back on it seriously. There are clinical trials investigating Indomethacin. I would like to offer to anyone who is on Xtandi (enzalutamide) to check out this option. Here is the link to the research we found: health.ucdavis.edu/urology/...

God bless you!

[monte1111 in reply to luvhealth]

Thanks for the link. May make me do some rethinking.