Just an update on my father: he’s doing well, still has trouble walking a little bit and can’t stand for too long, he feels a bit of a muscle pull/stretch on his calf/leg as well but other than that he’s been doing well. He’s taking classes on diabetes and how to maintain his diet and have a healthy lifestyle so he’s been busy with that. He’s been making changes to his diet everyday which I’m proud of. He has his check up tomorrow so please keep him in your prayers!!
Just a question for everyone, if you have taken/are taking zytiga, how long have you been on it and what are some choices after zytiga has failed?
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chocolatelover_123
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When Zytiga fails , the cancer is castration resistant. He could qualify for Provenge, a vaccine that could be more effective if given earlier.
If he did not have chemo , he could be treated with docetaxel, if he had docetaxel earlier he could be treated with cabazitaxel.
Then there is the possibility of using an anti androgen, such as enzalutamide or even zytiga again since in some patients chemo could resensitize the cancer to abi or enza. Xofigo (Ra 223) could be another possibility, if there are bone metastases and there are not visceral metastases.
Treatment with Lu 177 PSMA could be other possibility.
If the cancer has mutations related to DNA repair or MSI-H, and/or MMR deficits, he could be treated with drugs such as Olaparib and/or Keytruda. There are clinical trials for Lu 177 PSMA treatment and for Olaparib and/or Keytruda or similar.
What’s your background Tango. You’ve become quite active on this site recently with great input. You seem very knowledgeable in all things PC. We need men like you for sure.
This discussion intrigues me. after reading Tango and some commenters, I have a few questions.
I have been taking Zytiga for 9 months. I have tolerated it well and in the last month or so my hot flashes have practically disappeared. I get my labs monthly. PSA has been in the low 4’s for the last 3.5 months. Every other lab I watch is low normal. ALP, AST, ALT, LD, and Glucose are all near the low end of normal and steady since spiking in May and June just after an Auximen scan lit up with hot spots in multiple locations in my skeleton.
Steady between 4 and 5 in PSA satisfies my Oncologist. I feel too good now to argue, but I wonder why it won’t go lower.
Leo2634 mentioned that the Dr. thing Provenge works better when PSA is lower. 4 is not alarming my Doctor, but is that low?
What does Zytiga failure look like?
The Provenge discussion intrigues me along with making a cocktail of Zytiga and one of the effective chemo drugs. I read so much about ADT/chemo being better earlier, that I wonder how to evaluate the probability that it will help.
The next to the last thing I want to do is begin chemotherapy before it is necessary. The last thing is to consider it too late and miss an opportunity.
Is Provenge covered by Medicare or is it a private pay situation?
Thanks again to members of this board who share so generously.
I've been on Zytiga for two years now so far PSA has been 0.1 since first month treatment. I also have had Provenge infusions back in June. My Doctor says that they now believe Provenge works better when PSA is low. The Provenge is immunotherapy that is administered in three blood collections of your white blood cells and then three infusions back in you after harvested with the Provenge to make them a sort of super cells to attack the cancer. The whole process takes around six weeks to complete side effects are mild I only had bad chills for a few hours. Best of luck Never give up never surrender. Leo
Ride the Zytiga for all it’s worth . Just deal with the here and now . Keeping him comfortable if possible . Prayers for the upcoming dr visit . 🙏
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Zytiga 
Radiation followed by zytiga or Zytiga
Zytiga 
