Appointment with MO what to do after abiraterone ( other version of zytiga )

[Nirman]

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

[Tall_Allen]

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.

[Nirman in reply to Tall_Allen]

Okay thank you can you tell me more about radiographic progression

[Tall_Allen in reply to Nirman]

They check on a scan to see if there are more metastases.

[Nirman in reply to Tall_Allen]

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

[Tall_Allen in reply to Nirman]

Usually done with bone scan/ct

[LearnAll]

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.

[Nirman in reply to LearnAll]

Sure thank you

[Magnus1964]

PSA is still low, milk the abiraterone for now. When he gets significant increases in PSA he could go on casodex or xtandi.

[Vsahay in reply to Magnus1964]

Does casodex work in castration resistant paitents?

[Magnus1964 in reply to Vsahay]

If your father never had it before then he should respond to it.