Confused xtandi or zytiga

[Bobcat64]

Newby. DX 1 year ago mCRPC bone Mets one spot top of pelvis. Had biopsy 3+4. A Dx urologist put me on eligard + firmagon 6 months 0.1. Off of firmagon. MO on xgeva Psa steadily increasing to 12.3 now wants me on xtandi. Scared about what to do? Age 79 active and in great shape.

[Magnus1964]

I would think radiation would be the next step. But if your doc says ADT drugs is the next step I would think casodex might be better. It has fewer side effects. Then move on to zytiga or xtandi.

[Peterd110 in reply to Magnus1964]

Can radiation to a single bone met reduce psa?

[Magnus1964 in reply to Peterd110]

If it is localized to a single spot, yes it would.

[Bobcat64 in reply to Magnus1964]

Iron also took me off casodex when psa started to increase.

[Magnus1964 in reply to Bobcat64]

Why would iron take you off casodex? I have had iron infusions at times because ADT drugs lowered it.

[Bobcat64 in reply to Magnus1964]

Sorry computer changed Urologist to iron. On another point has anyone on this blog ever tried Joe Teppins or Rick Simmons treatments.

[Tall_Allen]

Your DEXA scan showed osteoporosis already?

Consider "debulking" the cancer in your prostate and the single bone metastasis with radiation:

pcnrv.blogspot.com/2018/09/...

After that, the following chemohormonal sequence seems optimal:

pcnrv.blogspot.com/2019/12/...

[tango65]

Consider discussing a CT and bone scans (it has been more than 1 year and PSA is increasing reaching 12) to see if there are more metastases. If there were 3 or less you could discuss radiation to the prostate and possible whole pelvis and metastases radiation if possible.

[Bobcat64 in reply to tango65]

Just had pet scan and still 1 Mets.

[tango65 in reply to Bobcat64]

Good. Discuss treatment to the prostate and to the met. The Stampede trial showed an advantage for radiation to the main tumor if there were few metastases.

thelancet.com/journals/lanc...

Best of luck on this journey !!

[ctflatlander]

I'm oligo also 4+4. Consider debulking the prostate and radiation to the tumor. I've had success with both based on the Stampede trials. Best Bob

[Bobcat64 in reply to ctflatlander]

Hey Bob thanks for the info. How long since your dx.

[ctflatlander in reply to Bobcat64]

I was diagnosed Nov 2017, been on Zytiga,lupron since 76 yr.old, Bob

[larry_dammit]

Don’t be afraid of the Xtandi I’ve was put on it after my chemo 38 months ago working good for me. They are also doing ADT. So have to start all over on the muscle mass. 69 and counting