Hello, guys. I haven't been on line much, as we've had a rough couple of months. We went to Europe in early January. My husband had some pain, but got through the trip beautifully. A few weeks after getting home, he picked up a produce bag at the grocery store and snapped his upper arm bone.
He's since had surgery, from which he has not recovered well. His particular kind of cancer is lysing bones. Because lytic bone lesions are unusual with PC, the doc did a bone marrow biopsy and told us it could be multiple myeloma. It turned out not to be and the cancer showed no additional mutations, so he's moved on to Zytiga. However, he's still in pretty intense pain and basically moves from bed to chair and back. I'm still dressing him and prepping meals, as he can't really use the arm.
1. Does anyone have any tips for the stomach pain and nausea associated with Zytiga? We've tried Nexium and Zofran with no luck. He responded to IV Reglan in the hospital...is oral Reglan worth trying? Any other suggestions?
2. He's been taking hydrocodone and Aleve, with an Atavan topped on for night. It's barely touching the pain. He also had a weird incident where he got an unbearable pain in his jaw and I had to take him to the ER. They gave him drip Tramadol and he woke up in the morning and the pain was gone. Still have no idea what happened. MRI showed no fracture or notable lesion. We're working on getting THC gummies, despite his concerns, because he's so desperate to try something else. Hydromorphone does not work for him. Any suggestions?
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OMG how awful! I originally had a mix of blastic and lytic lesions, and responded well to standard treatments for about a year. This January I was diagnosed with neuroendocrine PCa, and both my oncologist and now my urologist agree it was probably there from the beginning. As the urologist put it, my disease never acted like normal prostate cancer. Perhaps your husband has something similar going on? It's just a conspiracy theory until you have proof by biopsy, unfortunately.
1) no great advice on how to deal with stomach issues. I've found ginger chews can help, as well as Tums. I've had mixed results with zofran and pepcid.
2) the general strategy of combining pain relievers that work differently seems to be the best approach. I've found oxycodone works better for me than hydrocodone. Is he also taking acetaminophen? If he's on vicodin or percocet, it will be part of the drug and you don't want to add more. Finally, you might consider trying gabapentin instead of the benzo. I have no experience with gabapentin, but it's more commonly used for nerve pain than benzos.
If he's still in pain while taking an NSAID, an opioid, and a benzo, then it's pretty severe pain. For me, a low dose of oxycodone and clonazepam and I'm either pain free, or could simply care less about any pain, and generally get a good night's sleep.
Best of luck to you and your husband! I've read some of your old posts, you two need a break!
How are his bowel movements? Opioids are constipating, which can cause belly pain, and they can cause nausea too. Medical marijuana can relieve nausea, and allow him to reduce the dose of opiates.
He's had some constipation so I've added senna and mirilax (not at the same time!). This issue has seemed to resolve. The pain for him is in his stomach toward the top, like with GERD, but PPIs and antacids don't seem to help. Plus, he has mild nausea.
I've been on Zytiga for almost three years now and no significant side effects other than the expected ones hot flashes etc. I was told by one of the Brothers here to take it around 6:00 am with a full bottle of water at least 12 oz. That advice has worked great for me. I take my Prednisone a few hours later with Breakfast. Leo
I am one year in with a serious APC diagnosis. I have had ADT, SBRT radiation and prostate surgery as part of a successful round 1.
I wanted relay to your husband my version of the THC edibles discussion. There really is a difference between medical use and recreational use. Before cancer, I never had any use for THC edibles. Through a month of radiation and then surgery they were very, very helpful. They enabled me to go very light on the narcotics. I always took the same dose 10mg. Then one day, they made me high - and I decided that was my indication that I did not need them anymore.
My 2 years w/ Zytiga (am on holiday now) summarized below.
Year 1 - took 1000 mg at 0400 = significant stomach cramps, significantly reduced w/ 500 ml of water. Significant leg cramps.
Year 2 - took 250 mg at noon w/ healthy meal (probably actual dosage swung all over the place - no attempt to weigh out the fat content of my meal). No stomach cramps. Leg cramps almost gone.
My UO in year 2 at first reduced my prednisone dose to 1/4th of original dose - experienced rapid deterioration in health, down to walking 6 or 7 minutes before pain and fatigue. Stay or full or at least 50 % of prednisone dose you were taking with the 1000 mg of Zytiga.
All approaches worked - excellent response in terms of PSA which was not detectable in either year 1 or 2 using standard tests.
Probably was overdosing some days when taking it w/ lunch.
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