My dad is diagnosed with stage 4 metastatic 4+4= 8 Gleason score metastatic with mets over pelvic bone and spine so we started hormone therapy + abiraterone + 5 mg Prednisone two and half years back his psa was 13 when he was diagnosed after starting therapy it was nadir 0.010 now it started rising few months back after remaining steady over 2 years from therapy it's 0.150 right now so I am wondering is abiraterone stopped working now? perhaps he's going to be castration resistant from being hormone sensitive...are there chances of psa may stop at some point?.. please guide me with your suggestions and options about what we can do next...he is physically very fit with no symptoms or pains at all except rare episodes of hot flashes...on some days walks 2-3 hours everyday on raw vegan diet most of the time foods like green tea brocolli garlic Curcumin pomogtanates please suggests any alternative supporting natural therapies or supplements
Appointment with MO what to do after ... - Advanced Prostate...
Appointment with MO what to do after abiraterone ( other version of zytiga )
That is still a very low PSA. I don't think anyone would give up on abiraterone unless PSA gets much higher (above 2) and there is radiographic progression. He can discuss switching to dexamethasone to extend his time on abiraterone.
Okay thank you can you tell me more about radiographic progression
They check on a scan to see if there are more metastases.
How about can we compare new MRI with old one as I prefer it as a no radiation screening....or only psma pet ct scan will work
Usually done with bone scan/ct
DoNot stop Abi until PSA remains below 2.0. Intensify use of anticancer foods and other natural therapies to keep PSA below 2.0.
His PSA Nadir 0.01 is excellent and indicates survival for many more years.
PSA is still low, milk the abiraterone for now. When he gets significant increases in PSA he could go on casodex or xtandi.
Does casodex work in castration resistant paitents?
If your father never had it before then he should respond to it.
Update regarding divergent advice about adding Zytiga to Lupron when PSA undetectable
PSA Dropped after 22 days of Zytiga
Effectiveness of ADT
Addition of Metformin after Progression on Abiraterone.
