After Zytiga & Extandi....?

[4luvofrob]

Hi ... I cannot tell you how grateful I have been for this site over the past 9 years!

My Rob is a Gleason 9. He had his prostate removed in 2012, received radiation at Datolli in Sarasota, and was on Avodart, Zytiga, and Firmagon until it appeared that the Zytiga was failing last year...PSA was increasing and an Axium Scan revealed a met on the hip and a nodule in the pelvic area....and he was taken off the Zytiga and Avodart. He was given the Provenge treatment which was completed this past December and started on Xtandi, one and then, two pills in February when his PSA was 4.05, We have now learned that his PSA is up to 12 and his oncologist is going to Telehealth meet with us on Tuesday. Besides increasing the Xtandi (Rob nor the doctor feel he will be able to handle it at a higher dose.), what other treatment options would you suggest? Thanking you and praying for your safe keeping and good health during our present Covid crisis.

[Tall_Allen]

Docetaxel.

[4luvofrob in reply to Tall_Allen]

Thank you, Tall_Allen!!! Blessings, b

[Fairwind]

R-223 can be very effective against bone mets...For me Jevtana (Cabaztaxel) worked better than Doce and had fewer side-effects...

[4luvofrob in reply to Fairwind]

Thank you, Fairwind...that is very helpful!!

[DarkEnergy]

Also, discuss the "possibility" of rechallenging Zytiga or Xtandi after Taxotere (Docetaxel).

There's been increased interest in late, regarding sequencing PCa treatments. The last 3 years has been amazing,

Helpful healthunlocked link, relevant for you:

healthunlocked.com/advanced...

[4luvofrob in reply to DarkEnergy]

Yes, I have read about that and it is very interesting...Zytiga worked very well for Rob for about 5 years with very tolerable side effects...beyone fatigue and muscle atrophy...

[Hidden]

First-line chemotherapy Docetaxel and second-line chemotherapy Cabazitaxel are both good, proven treatments.

Don't be afraid of chemotherapy. All chemotherapies are not the same as far as side effects go. These particular chemotherapies are quite tolerable for most.

I did 6 cycles of Docetaxel and it was not that bad. I would certainly do it again.

Cabazitaxel has less side effects for most. That will most likely be my next treatment.

Wishing you and him the best.

[4luvofrob in reply to Hidden]

Thanks, Gregg...that is encouraging...b

[Hidden in reply to 4luvofrob]

I felt crappy for around the first week, but I also found a psychological benefit to that. That might sound strange, but you really feel like you are doing something against the cancer. You have a goal and a focus to get through each cycle. I was definitely happy to be done with it, but after I did find myself missing having a more active role in fighting the cancer.

[MarkBC in reply to Hidden]

I never thought of it that way but I agree. I also agree with you that chemo was not as bad as I expected it to be.

[4luvofrob in reply to Hidden]

Thank you for the encouragement, Gregg...I will share it with Rob. Take care.

[4luvofrob]

Thanks, once again!!! I will definitely share your words with Rob....He and I both hoped he would never have to do chemo...but your experience is encouraging....My biggest fear for Rob is that it will wear him completely down...he is very fatigued and week now....but we will discuss it all and what the others have mentioned when we meet with Dr. Dawson on Wednesday.....God bless and keep you and all who have been so gracious to reply in such a timely and helpful manner. XOXOXO

[erjlg3]

You're an amazing Caregiver 💗

My continued love and prayers for both of you and prayers for this appointment to help Rob to get better and stronger.

🌻

[4luvofrob in reply to erjlg3]

Thank you and God bless you, precious friend....

[Break60]

Did he gave RT to pelvic lymph nodes at Dattoli or sbrt to bone met? I never jumped to second line ADT and instead went to estradiol after sbrt to bone mets. See my profile.

[4luvofrob]

Thank you ...Break60.....Rob's radiation was what Datolli called DART....it was to pelvic lymph nodes and to a spot on his pelvic bone though it was definitely confirmed to be cancer...

[Survivor1965]

Not a doc to hard to prescribe anything, but when I was really bad I had Jevtana and carboplatin at the same time. Something my Onc in MN and Kwon at Mayo had come up with, and it worked well, knocked it right down. Then Lupron/Xtandi since. That was 3 1/2 years ago, PSA undetectable today. Btw, I started in 2012 also. Keep the faith.