Prednisone from 10mg to 5 with Zytiga?

[Dachshundlove]

Anybody here successfully cut their adjuvant prednisone dose while taking Zytiga (without major side effects)?

🙏

[LearnAll]

I am one who had success with 5 mg /day prednisone with 250 mg Abiraterone with a full big cup of full fat yogurt. I am doing this for last 3 months and PSA has been falling continuously.

Last reading :PSA 0.4 and ALP 59.(on 12/31/2019

(disclosure: I am adrogen sensitive and not castration resistant yet)

[Patrick-Turner]

The amount of prednisolone taken while on Zytiga is usually 10mg a day, and it is to replace what the adrenal glands normally make. Lots of ppl focus on the badness of prednisolone but really it ain't that bad at all when you consider the side effects of Zytiga. I have a friend who takes 20mg of pred a day to control pains and aches and he is 62, still doing hard building work, and no Pca and no Zytiga, and probably he may have side effects from pred that are not good, but then nobody gets old without side effects of getting old. During chemo after Zytiga I continues pred because doc was not sure my adrenal glands had come back to life after quitting Zytiga. Anyway, doc was horrified when I took a 25mg pills for a month, after getting scrip wrong, and then I stopped for a month or more, and all that time I felt no difference at all to my life. I weaned myself off pred and have not taken any for many months now so I never became addicted to it.

I think our minds should focus on the bigger problems of having Pca and the drugs used to slow it down or kill it.

While we do that we should try to maintain good health and fitness where possible.

For a week now, the bush fires in south east Australia have been so bad and created so much smoke I have been forced to stop cycling for a week. Its now 10:30am, Sunday, and the roads are very quiet, and nobody is out walking or cycling and the sky is overcast and dark; it looks like it might rain, but its smoke,

and visibility is less than 500M in places, and until we get a breeze from the west, the smoke will linger.

Air quality is worse than the worst that is seen in Beijing, Mumbai, Jakarta et all. We are hoping is clears soon.

OK, so I am having yet another forced holiday off the bicycle. I am still OK though, living indoors, windows all closed, not breathing vast amounts or air like when I am out on the bike.

I do not need to be amoung some young folks who might be passing the joint around for their Sunday Jolly like I remember we did back in 1970. I am not in any need of taking any pills for any mental condition. How did I survive to avoid that? Good question. I don't much know, and I don't care about what I don't know if I don't need to know all about all things, so If I know enough I am fine.

A neighbour is 7th Day Adventist, and insisted "The Lord" will soon come again to Earth to save us and establish the Kingdom of God on Earth and He will stop all bad stuff happening, and apparently, the only book he's read is the Bible. Have no fear of the Lord coming and murdering billions of ppl who refuse to catow. It won't happen. I remained polite about the way he described Nature with an ignorant mind, and bid him a very good day. His mind is full of silly superstitions and mutually shared insane beliefs; things that I dumped at 17 remain strong in his mind at 57. But I just said we need only be mindful of 7 virtues and 7 vices, and act accordingly, and leave out all ideas and worship of any God or other supernatural things, and all will be well, and thus be a good human rather than an evil one. My neighbour knows I have a fine sense of right and wrong, even though I am a secular heathen, so he has nothing to fear from me. He naturally worries, is anxious, and must have the daddy in the sky and he cannot see that the daddy is just not there, and is just a communally imagined thing shared with others who feel anxious and worried about existence, and they need the daddy to save humanity.

Well, many religious ppl have tried. Jesus sure did. But then so many wars have been fought over beliefs that I believe religions can be very dangerous.

So enjoy life while alive, no need to worry, and you cannot avoid dying. So I'll get back onto bike when smoke clears and I can cycle when the mornings are cool again. Lunch soon at my local café. Always someone to say hello to, maybe talk about life, and then I get to read newspapers. Wow, what a good time. And no mobile phone, wonderful.

[Cisco99 in reply to Patrick-Turner]

Kinda veered away from prednisone, but terrific post anyway.

[Patrick-Turner in reply to Cisco99]

Its Sunday. It has stayed overcast here with clouds of smoke. I give freedom to anyone stating their beliefs, and I hope they question mine.

Prednisolone is a not a big deal to me, something that causes me to have very little worry. Just don't take too much for too long.

I had great little lunch with a vegetable sandwich and two mugs of coffee, and a discussion with a young bloke about bushfires which now encircle my city, Canberra. He wants to advise local Govt on what worst thing could happen during near future. With any brisk breeze of say 40kph and hot days, these fires could burn their way towards this town like they did in 2003 when we lost 500 houses and 4 died, burned alive, and there was a local small fire tornado which snapped hundreds of big trees off half way up.

I am probably situated well to avoid the fire.

Meanwhile, I don't know if I am an atheist or not, because to deny there is anything "out there" greater than ourselves is bullshit. Has anyone noticed Nature? Its greater, its right there, we are part of it, but wise folks don't bother trying to humanise Nature, like they do with any imagined God. Nature has no personality, it is just there. If we bash it around we can expect it to react, its part of a natural law, "to every action there is an equal reaction" and prayers don't help to make Nature spare us from disasters or illness or make us win lotteries. I have survived with wits around me, seeing much of the poop coming at me before it hit me, thus avoiding it. All without a single Hail Mary.

Yesterday, it was 44C max at 4pm and set a new hot record. Its was 38C at 9pm. Today its much cooler, only maybe 27C, due to thick clouds of smoke.

Breathing the air here for a day might be as bad as having 2 cigarettes. I think I'll survive the present weather mess.

Don't worry, Be happy,

Patrick Turner.

[Cisco99 in reply to Patrick-Turner]

Whew ... I don't pray, but I am thinking of everyone where you are, and hoping the whole world sees, and understands what we are all up against.

[Patrick-Turner in reply to Cisco99]

The fires in USA were bad last season. Now the volunteers who fight the fires may spend time in USA then here, then in USA, with little down time.

Scientists predicted all this crap more than 30 years ago. Its not all due to Global Warming though. Australia has a long history of very long droughts affecting huge land areas, and before Europeans set foot here, the local natives were here for at least 40,000 years and they grew to understand the necessity of burning the bush to stop fire intensity if they did not burn regularly. But their efforts were mainly around areas they liked to settle, such as around Sydney which to anyone alive seemed like a fabulous place to linger as a hunter-gatherer in a tribe.

But away from favoured settlements there were humungous wild fires which occurred when temperatures went above 30C and there was a long drought. These fires burned from one side of Oz to the other, quite un-stoppable so the natives needed to know where to run to get out of the way when such a fire came at them. They didn't have houses to protect. Many died, burned alive with fleeing wildlife. The cycles of the recurring bushfires continue, but are being made ever more severe by having average temperatures higher, thus peak maximums can be a lot hotter.

The world wide increase of summer wild fires is still not enough to make the biggest governments wake up to stop CO2 emissions which means huge expenses which means hugely greater national debts of trillions of $$$, which are already a worry because nobody knows what happens if the huge debts remain un paid.

So private ppl must do it on their own, at their own expense, so installs of solar panels is huge here.

But the records of heat will continue upwards, no matter what we do. As a species, we tend to do too little too late to save ourselves from disasters that creep up on us. When all of us do realise what's happening, ppl will divide into conflicting camps where those who can pay to avoid the worst effects of Global warming won't pay a cent to save the poor. Its a bit like Health cover. Many ppl want to pay their own way to get best Pca treatment, and they do not want any Govt to impose a tax to fund any Pca treatment for the poor; its Socialist, Communist, Left Wing, Evil etc. But here, we have Medicare that pays for all things once you take yourself to a hospital and the care can be quite magnificent, and the rich don't grumble about paying taxes to fund Medicare. They are welcome to go to a Public Hospital. The rich do grumble about the eye watering prices some doctors charge when working outside Public Hospitals.

The effect of ppl paying big $$$ for private insurance to pay for treatment not available in Public Hospitals is that the doctors charge high. But a large swathe of doctors love to work in the Public system where they get a fairly good income, without being greedy, and they just love their work, and their team, and fixing YOU, asap, if they can.

Its been a lovely day, despite the smoke. And the smoke is not the work of an angry God, or angry Satan, its just Nature being natural.

Patrick Turner.

[LearnAll in reply to Patrick-Turner]

Am I on a political forum ? Please don't hijack this thread from "Prednisone dose" to "wild fires" Come back to subject...you have moved too far in the wilderness.

[Patrick-Turner in reply to LearnAll]

Yes, I often drift off topic of Pca. But part of how we deal with it involves getting medical treatment and the cost of that varies due to political control over medical services provision, so cost must be a factor for how some of us fare when dealing with Pca. Some deal with Pca with prayers, and I wish then best of luck.

I am human, and cannot be a one eyed one focused on only one issue.

Its cooler here today, and smoke from bushfires has lessened, so I will soon cycle 20km to local hospital to get follow-up talk to doc about a bowel blockage 5 weeks ago caused by adhesions of scar tissue from 2010 surgery for RP to bowel. I am OK now. But additional troubles can come at you sideways in any fight with Pca.

Patrick Turner.

[Hidden in reply to Patrick-Turner]

Anyone who wants to check out the above remarks about God and the bible can visit the website woodwardworks.com

I'm Stage 4/Gleason 9/innumerable bone mets/some lymph node mets, 79 years old. Started PSA in 4000 area and now have undetectable PSA and T using only Lupron, Zytiga and prednisone (starting at two 5mg tablets daily, but changing to a single 5mg after reading the manufacturers docs for non castrate resistant patients). I suffered no side effects by reducing 10mg daily to 5mg. Lupron, Zytiga, and Predisone have kept me pain free for over two years so far.

[Patrick-Turner in reply to Hidden]

I tried to go to woodwardworks website but was blocked because its not secure. If you want us to consider what is there then spell it out here in a summary.

You are really lucky to have big drop of Psa 4,000 to undetectable. We all will respond differently to treatments. I hope your luck continues.

Patrick Turner.

[Hidden in reply to Patrick-Turner]

Thanks Patrick-Turner. The website is secure when accessed via woodwardworks.com

It looks like the period (.) at the end of the sentence was taken to be part of the website name. Sorry about the confusion. I have edited my text (above) by omitting the period from the end of the sentence. You should be able to reach a secure website by using the edited text.

[Cisco99 in reply to Hidden]

I was a believer until my daughter committed suicide. I prayed for her, went to church, did Bible study. Nobody in the church had an answer for why she suffered so all her life, and then snuffed herself out. So I moved on.

[Patrick-Turner in reply to Hidden]

I'll try again later to see that link;

I have to soon cycle to hospital for follow-up meet with surgeon who fixed me up 5 weeks ago after I got bowel blockage due to scar tissue adhesions from surgery in 2010.

Someone asked me where I live. I am not living where the bushfires are.

I live in small city of Canberra, Australia's National Capital about 300km sth west of Sydney. I am not where bush fires have burned these last months but smoke from them has stopped be cycling. But today, smoke has cleared enough and temperature is low, so I can cycle.

All is well for me right now. But summer is far from over, so we don't know what will come later.

Patrick Turner.

[Hidden in reply to Hidden]

Great results

[monte1111 in reply to Patrick-Turner]

7 vices? I seem to have missed one. Damn!

[Patrick-Turner in reply to monte1111]

There are probably more vices and virtues than 7 of each.

There ought to be more than 10 commandments as well, maybe one to outlaw worship of any God. Just commandments to tell us how to be good, and not bad, and to damn well just get on with it while you are alive.

Thou shalt not have wars, feuds, inquisitions, torturings, burnings, pogroms where beliefs about God is not as specified by darn clergy. This would be and A grade 11th commandment.

Patrick Turner.

[cesces]

Ta has rather consistently insisted this is a non-issue.

All you are aiming for is to replace what is being diminished by the Zytiga. The only goal is to get it up back where it belongs and not more.

It would seem like a fair portion of people probably need to do some pill cutting to get it right.

[Flash64]

I only take 5mg a day. My Onc has a number of men who do the same. no issues in over a year doing this.

[tango65]

Prednisone is administered with Zytiga to avoid an increase in ACTH and a higher production of aldosterone by the adrenal glands., which could cause edema, hypertension and hypokalemia.

Zytiga can be taken with 5 mg of prednisone. If hypertension, edema or hypokalemia develops it should be increased to 10 mg.

Some oncologists do not use prednisone, they treat the patients with eplenerone (Inspra) an aldosterone receptor blocker in a dose enough to avoid hypertension , edema and hypokalemia.. This could be useful for people with diabetes, since prednisone may complicate the control of the glycemia.

[Lettuce231]

Hello,

Yes I've reduced the Zytiga to 500 mg daily and the prednisone down to 5 mg daily, it's about a year now, PSA continues to fall, I also have the 6 monthly injection and the side effects have been less. Overall the result is very encouraging.

Always take your Zytiga with a meal, it works better.

Phil

[Lisaron628 in reply to Lettuce231]

With a meal? My husbands is prescribed on an empty stomach.....

[westof in reply to Lisaron628]

Hmm... I take Zytiga on an empty stomach, wait an hour and then take 5mg prednisone with a banana.

Best

[Lisaron628 in reply to westof]

We take it an hour before dinner. And his prednisone is at noon and bedtime.

[Lettuce231 in reply to Lisaron628]

Hi,

I have been taking 500 mg with a breakfast of egg and bacon on toast, plus a yoghurt, every morning for about a year. I wrote a blog on here sometime back " eat drink and be merry " one size doesn't fit all.

I am talking absorption rate, with food, your body can absorb the Zytiga better and therefore you need not take so much. That way you can cut the prednisone accordingly.

Think who makes the money out of you and why, an empty stomach is just that, where's the Zytiga going to go ? Food is like a sponge.

My PSA was on the up, this was a last chance, I decided to experiment, it's worked very well, I think I was on a + 6 and rising fast, originally 150. Now it's 0.111 falling.

I feel fine too, just the tiredness and aches, but that's what you get when you insulate your loft space 😂👍🏻.

If Ron ? Is having a three month check ups, he could always try it or if you are worried ask the doc, there are many guys now doing the same.

Best wishes.

Phil

[Lisaron628 in reply to Lettuce231]

I will definitely discuss with his doctor. We see him every two months and blood test once per month with every third month getting zometa.

[Schwah]

I did go from 10 to 5 With no additional SEs. You may wish to do blood work a little more often to make sure the lower dose isn’t having any negative impact. Sorry some of these answers went a little off road. Lol

Schwah.

[westof]

Hmm...I take Zytiga, prednisone5mg,Lupron and will continue for another year and a half (my MSK MO says that I'm "slightly anemic and treatment is the culprit".

So far, since I started Zytiga in March: PSA steady a 0.014, Testosterone<12 and liver enzymes better than before dx (except for a 2 month spike after starting Zytiga).

Best

[Cmdrdata]

I was on the 1000mg Zytiga + 5 mg prednisone for 19 months with PSA at < 0.01 and castrate level T (no Lupron shots). However, my BP is a bit off, steady systolic =150 and diastolic = 80, and blood glucose around 110. So for the past 2 months I’ve tried the 10 mg prednisone, one the morning and one at night. There has been no change. all other blood tests remain in normal level. Will probably return to the 5 mg prednisone. Still have enlarged breast, lower energy, but still active, no libido and no erections.

[PGDuan]

I started with 10mg one year ago, while starting ADT + Zytiga after RALP and adjuvant RT. The 10mg made me feel hungover so I cut back to 5mg and have been fine ever since. PSA <0.05 and 13 of 18 months behind me. Best of luck.

[TEBozo]

I started and have stayed on 5 mg. 750mg of Zytiga BTW