Father turned castrate resistant with psa of .09 and a small met at humerus. MO advised for SBRT followed by addition of zytiga.
What is the average duration Zytiga will act. He was on ADT for 3 years and lowest psa was <.008. Also with addition of wysolone is there a tendency to put on weight? Any other side effects as well?
Also should we also add biclutamide as his T was 19.
Any other suggestions please. Thanks
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Ayra1
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I have been on Zytiga since May 2018 and I’m scheduled for a two-year treatment with it I take 1000 mg a day. So far so good my PSA is undetectable this whole time and I sure hope it continues that way after I stop taking my medication and my hormone therapy
The hot flushes I had from zoladex already , they are no worse , the night time urinantion needs are variable but no worse than before I started zytega .
I did put sone weight in at first but upped my exercise and cut out lots of rubbish in my diet and am now probably the fittest I have been for a long time .
I am a runner now 55 , was 49 on diagnosis , already metastatic psa 342.
I have run further since diagnosis , see attached for what I did last week !
Yes prostate cancer and treatment is not fun but if you try hard and are lucky it has not got to be an instant end to life as you knew it .
I did ADT (via estrogen patches instead of lupron), zytiga (w/prednisone), and after stopping ADT I did bicalutamide, dutasteride, and continued the zytiga (and pred). Never had weight gain. Lot's of fat loss and muscle wasting. Also gyno (went away). My PSA is zero and I started on high testosterone injections last year. PSA is still zero. Lots of muscle gain and some fat loss. I'm still on the zytiga (and pred) and also dutasteride, finasteride, and an aromatase inhibitor.
When I was on ADT, even though my muscles were wasting away, I worked out a lot and ate a plant based diet. I wound up feeling like the guys who gain weight aren't watching their diets and/or are not exercising (exercise, low fat content, and high lean mass are all very highly correlated with PrC survival).
My husband is also doing SBRT (3 sessions) 4/30 to T5 and T7. His PSA is 2.2 and T 69. He has been off Lupron for 10 months. He has not taken any medications since his last Lupron shot over a year ago. Alk Phosphatate is 65. 10 months ago T6 had an uptake on a PET scan as well as a small spot in the hip. His ALK was 115. I gained respect for ALK as it doubled when a tumor attached to T6 and started damaging bone. SBRT to T6 and the spot in his hip were successful. But now 10 months later, we have "smoldering" on T5 and T7.
We are hoping for a long term response from just the SBRT. We enjoyed 8 months nearly undetectable without meds until the disc next to the original issue with T6 started smoldering. I'm somewhat relieved the cancer this time is right next to T6 and has not spread elsewhere. I just thought I would throw out our experience since they are similar. We consulted with several doctors at Hopkins and Mayo and no one mentioned him needing any meds so far. Charlie was placed on 14 months of Lupron when he did pelvic radiation 2 years ago so they aren't opposed to Lupron.
Our local Urologist my husband speaks to a couple times a year, I feel is angry my husband is not on Lupron. He stated my husband is hormone resistant with his T at 69. I thought about it and called him a couple days later and asked is he was confused that Charlie is on Lupron, because he is not. I think he assumed this and he wanted Charlie to take Provenge. Seemed really strange since 6-7 top doctors did not mention meds during insults to do SBRT in a few days.
Very good question which I wish I knew the answer to sharing your concerns. I’ll just share our experience which may help you. Sorry if it’s so long!
T6 was radiated 8/19 SBRT. Treatment seemed to work. But PSA only made it down to .2 from 1.3. New Choline 11 PET in 3/20 was inconclusive . Our radiologist looked at the PET and said T6 looked like it may not be cured of cancer and he thought he saw something on T5 and T7 and he was concerned about “overlap” of treatment of SBRT. I think what he meant was T6 could not be radiated twice to answer your question I hope. And maybe this is because it’s the spine and worrisome for damaging the spinal cord. He thought an ablation of the spine was the second best option and referred us for that treatment. But, He ordered a MRI for another look not happy with the PET Scan before he decided defiantly. Unfortunately due to Covid 19, Mayo stopped elective procedures. They told us they’d call in 8-12 weeks. We were scared to death and asked if we should do Lupron as PSA was doubling every 4 weeks? The team said yes. We then went to Hopkins close to home to see if they were continuing treatment. We really didn’t want to do Lupron just because of Covid.
The MRI revealed that T6 was clear of cancer and healing very nicely and SBRT worked great in August. The Uptake of Choline was due to bone still healing and repairing. Hopkins also felt really good they could treat T5 and T7 without radiating T6 and having the overlap that was concerning on the first image. When Mayo restarted treatment and looked at the MRI they agreed with Hopkins and everyone had conscious.
If the SBRT on T6 had not worked and cancer was starting to form there again, I’m pretty sure all of the excellent doctors we saw would have agreed to not radiate the same disc twice.
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