Doctor asked to stop arbiterone due to constant uti+fever +side pain

[Kshiprakapoor]

Since last 2 months my father got uti 3 times along with severe right side pain near stomach and lower back pain. And fever keeps coming back I believe due to uti. Now his doctor has asked him to stop arbiterone + the medicine along with it. He said its been 2.5 yrs so it should be enough with these medicines. I have to check yet if he has suggested any replacement yet. But what's the reason to stop it? Tests are coming normal but not sure why uti, pain and fever coming back

[Vsahay]

Is his psa responding to abiraterone?Has it risen recently?Has he undergone scans to determine if there is a recurrence?

The abdominal as well as lower back pain could be due to uti and abiraterone could possibly not be a reason for it.Fever might also be a sign of infection.

Only if there is a rise in psa or new lesions have been identified on scan,should he stop taking abiraterone and move to furthur treatment options.

Hope this helps.

[Vsahay in reply to Vsahay]

There are certain infections which have effects over a long period of time such as E.coli.these can lead to symtoms for months.

If that is the case you can possibly look into naturopathy or homeopathy for UTI.

[Kshiprakapoor in reply to Vsahay]

PSA is normal. Everything is normal just the reason of uti infection reoccurrence is not getting known. He said stop the medicine because 2.5 yrs is long enough time and now everything is okay so no need to continue

[LearnAll]

Your Father's doctor does not know what he is doing. Tell him to first treat UTI before messing up with Dad's medicines. If he is so doing well on Abiraterone and prednisone then there is no reason to stop it. Rule is if its working ,don't stop it until its working.

I want to tell you once again : Get Urine Culture and sensitivity test, identify the bacteria and attack the bacteria with right antibiotic. Also, make him drink sugar free craneberry juice twice a day with spoon full of D Mannose powder . Give him anti inflammatory foods to control inflammation in his bladder wall.

In August 2019, I had severe UTI and my urologist kept avoiding treating it with antibiotics in spite of my repeated requests....I ended up in hospital for 2 days..my Oncologist was upset..she immediately did culture &Sensitivity and put me on Ciproflox . My UTI disappeared in 3 days and pain gone in 5 days.

First thing I did after coming out of hospital was to call my Urologist and told him, "I don't need to see you anymore..I need a more careful doctor"

Only God can save you and your Dad from ignorant and incompetent doctors.

[Kshiprakapoor in reply to LearnAll]

I am travelling from Singapore to India tomorrow, will be there tomorrow will sit and understand. As per doctor he told my father that now there is no need to continue this. Usually this 2.5 yrs are good enough for the medicine. There is no PSA rise. Not sure if he is thinking these are the side effects and should stop but that's not what he mentioned. As per him this is long enough time for this medicine and everything is okay now no need to continue.

[LearnAll in reply to Kshiprakapoor]

Shipra,

This experiment to discontinue Abi needs to be done after his UTI is eradicated. If UTI is not treated in timely manner, the bacteria ascend into kidneys thru ureters and causes what is called glomerulonephritis /pyelonephritis. At that point, a lot more antibiotics for longer duration are needed. The ureters start getting blocked due to swelling and the urine starts rising towards kidneys causing a condition called Hydronephrosis which eventually leads to kidney damage..

Are you going to Panjab, Delhi or any other city. ? There are so many very good private hospital and excellent doctors in India .Some top places are (1) Max super-speciality hospital Gurugram, Delhi (2) Apollo hospital and so on. You need to find the right doctors for your Dad.

Again, if his PSA, Alk Phos , Albumin, Hb and liver enzymes (AST and ALT) are within normal range.. there is really no reason to stop current treatment which is working well.

Once UTI and abd pain etc are controlled, in the future ,you can consider changing meds. By the way, very solid research in last 5 years have found that if Lupron is used along with Abiraterone, the overall length of survival is much more.

I would also ask you to look into some dietary and Ayurvedic meds as a complement to his medical treatment. Things like Pomegranade, Turmeric, Ginger, Onion, Garlic, Grape seed extract, Boswellia , Thyme, parsley, Oragano, Guava, tomatoes, Neem leaves ,Soursop leaves..Tulsi leaves ...all of these have anti cancer effects and help slow resurgence of cancer cells.

[Kshiprakapoor in reply to LearnAll]

Yes Delhi, his treatment is going on in Max only since beginning. I believe now the antibiotics is for longer period for 10 days. Yes I agree that why this sudden stopping of abi. Max is one of the best hospitals in India for cancer treatment. My father took my mother 10 yrs ago for her breast cancer treatment. Who knew he will himself get treatment there for prostate cancer. Cancer has really effected us mentally and especially my 2 younger siblings have really seen a lot. I just pray God to really give us all strength and more time of few years to stay as a happy family. Now both my mother and father are cancer survivors.

[Tall_Allen]

With abiraterone, one wants to use it as long as it is effective, as longg as side effects are tolerable - PSA, other biomarkers, and scans can be used to assure the cancer is not progressing.

[Kshiprakapoor in reply to Tall_Allen]

As per doctor as PSA is 0.01 since 2.5 yrs so now it can be stopped and he is not asking to start any replacement also. He said that since beginning I was stating it has to be taken for 2-3 yrs only and as PSA is negligible since 2.5 yrs its time to stop it. We are really confused what to do as he is the one handling the case since beginning.

[Kshiprakapoor in reply to Kshiprakapoor]

The only thing happening since last month is uti reoccurrence and side and back pain with fever. Bp was high once which came ok with bp medicines higher dose. After uti hemoglobin has reduced from 9.5 to 8.2

[Tall_Allen in reply to Kshiprakapoor]

The only reason to limit the time would be when one is taking it adjuvant to radiation therapy.

[Kshiprakapoor in reply to Tall_Allen]

Radiation was done 2 yrs back

[Tall_Allen in reply to Kshiprakapoor]

Hormone therapy after radiation lasts about 2 years, so that sounds right.

[Kshiprakapoor in reply to Tall_Allen]

Ah great, so this means we can follow doctors advice of stopping it

[Tall_Allen in reply to Kshiprakapoor]

I hope it had its desired effect.

[LearnAll]

Glad your father is being treated in one of the best hospitals in India. As Tall Allen said there is no time limit for use of Abiraterone. There are people for whom it has worked for 10+ years. By now, you may have known that there are people right here on this forum who are alive after 10 yrs ,15 yrs and even 20 years after being diagnosed with metastatic cancer. Everyone's cancer is different...some are milder, non aggressive type ..some are more aggressive type.

I want to emphasize that anti oxidant, anti-inflammatory foods and supplements does slow the progression and increase survival time. BTW, I lived in Delhi before moving to USA 30+ years ago. I still visit India every year.

[Kshiprakapoor in reply to LearnAll]

Yes correct that is what confusing us that abi can be continued for so long then why doctor is asking us to stop. And should we go against him, when we questioned him he just said now he dnt think so that there is any further need for this, it has to be given max for 3 yrs and in case negligible PSA it needs to be stopped

[LearnAll]

It can be confusing because there is no one straight rule. It depends. sk why he thinks it should be stopped (1) Because it is no longer effective (2) Because it is causing side effects (3) Just because it has been 2 1/2 years. First two reasons are legit but third reason is not not legit.

Even if you decide to stop , please make sure to monitor his labs (PSA, ALP, Albumin, Hb) very closely ,i will prefer every 2 to 3 weeks. If PSA starts rising on 3 consecutive tests ,quickly restart Abi.

Just because it has worked well for 3 years is certainly no reason to stop. This is actually a good reason to continue. Keep insisting to doctor to treat current UTI.

[Kshiprakapoor in reply to LearnAll]

Sure thanks for the input