I’m 66 years old and was just diagnosed with advanced prostate cancer. It has spread to bones, lungs and lymph node. My PSA was 29, grade 3 and Gleason score 7. I live in Canada and the standard of care is chemo or Zytiga. I’m on ADT. I was wondering if I should do chemo or Zytiga? I’m leaning towards chemo first, due to mets to lungs. I’m healthy otherwise and not on any other medications. I have found the information on this forum invaluable. It has given me a lot of hope. Thank you.
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Zozo123
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The Gleason score determined by biopsy is often upgraded after surgery. You may want to get a second opinion on the path results. It is unusual to have that many mets with a Gleason 7.
Thank you for the great article, You are a wealth of information. I’m not a candidate for surgery due to the mets. I have 2 spots on my hip, 1 lymph node in hip and multiple nodules in my lungs. I have no pain and no difficulty breathing. My PSA was 3.4 two years ago. Do you think getting a second opinion about the Gleason score would change the treatment plan?
Zozo- I am NIT recommending surgery, by any means. However- I thought I should inform you that there is presently a study going on comparing stage 4 met PC where some patients get meds, others get meds and radiation, and the 3rd group gets meds and surgery. My doc, a leader in the field, was frustrated with the available options when I wwas dx 7+ yrs ago. So-while carefully explaining to me the options and risks involved, I chose to be only his 13th metPC patient to get my prostate removed via surgery. There were many reasons he "suggested" this: i.e. they remove the motherships in breast and lung cancers: I ws young (54) and healthy and could tolerate the surgery; it would help prevent other future complications down the road (such as urinary......). AGAIN- I am not advocating, just letting you know that it is not out of the question.
I am in British Columbia. Diagnosed 19 months ago with bone and lymph node mets. I was given the same choice by my oncologist. We decided to do chemo and that was her preferred option. Reasons included 1) keeping Zytiga for use later on when the ADT starts to fail. Don't use up all your weapons at once. 2) My body is at its strongest now and better able to cope with chemo than it may be in the future.
Chemo is not fun but it was easier than I expected. The treatment has worked very well. I am only on ADT now. My PSA has been hovering around 0.3 since chemo and I'm feeling great, except for the usual ADT side effects.
Diagnosed in Nov 2018 with PSA at 163, Multi mets to spine, hips and lymph nodes. Initially on Zytiga, ADT, Zometa for about 8 months...and after having a chance to look further into Stampede trial and also a recommendation from MO....decided on docetaxel chemo treatment. Just done with chemo in Nov 2019. PSA is now at 0.192. Chemo is a lot more manageable that what i was being told...Everyone is different but for me it was very manageable. I am back at work and doing at least three times a week gym and 10 K steps every day. God bless
Docetaxel can be a hard chemo. I found it tolerable but it gave me more side affects than others. Curious have they mentioned Carboplatin? I would wonder if you have mets to the lungs that they might add that as well. I’m not a doctor so you might ask about that.
Thank you for everybody’s feedback. Does anybody have suggestions for drug sequencing after chemo? Should I have ADT+ Apalutamide/Zytiga or just stay on ADT until I become resistant?
Im stage 4, diagnosed on oct 2018, mets to the bone. At that time my doc said that no need chemo, so the gave me zytiga. And now jan 2020 after psma scan they told me that im already resistance with zytiga. So they gave me radiotheraphy for 5 times. And they suggest me to have chemo with docetaxel.
Im avoiding chemo and now im looking about Lu177 in german. Wish me luck
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When to start Zytiga
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Disease progressing after chemo. What now. 
Adding Zytiga Post-Chemo - necessary?
