Wait to take Zytiga for free or start chemo asap

In Apr 2020, my dad’s PSA was 2.83 and now (May 2020) it increased to 5.68. MRI result (excluding previous lesions) for lower part of the body in May said abnormal pelvis lymph nodes and no bone lesion. For bone scan in May (gamma camera SPECT – 17mCi Tc99m-MDP), images show abnormal increase of PX concentration at the sternum, lateral shoulders, left rib, multiple spine, sacrum, bilateral pelvis, femoral sides. He was just put a suprapubic catheter (SPC) due to urinary retention.

Before meeting the doctor, we read posts in the forum and plan to take chemo. However, the doctor said she would put my dad to a special program where he could take Zytiga for free (we don’t know how long this program is). The program will start after about 1 month from now.

Could you have any advice for us given my dad’s current condition? Should we wait to use Zytiga free or take chemo immediately? The SPC should be removed / replaced after 4 – 8 weeks. We consider financial issue, but we wonder if waiting is too risky for my dad’s Pca? He also has dacron graft from 2017 after an operation relating to aortic dissection but his cardiovascular health is OK now. We welcome and appreciate all your comments. Thank you in advance.

[DarkEnergy]

Use Zytiga now and add chemo ASAP!

Hey, don't let the Prostate Cancer pick up steam, hit it early and hard.

My favorite talk from an Oncologist that was diagnosed with Advanced Prostate Cancer:

grandroundsinurology.com/du...

[Hidden in reply to DarkEnergy]

Thank you, DarkEnergy! I read your posts, understand why you gave the above suggestion and will consider it.

[Hidden]

From what I could find in your posts, it looks like he got 2 years on primary ADT before he became castrate resistant. That's a good sign for effectiveness of a second-line ADT such as Zytiga. It also has less side effects than chemo. He could get more than a year out of Zytiga (I am at 2 years now with undetectable PSA).

If I were making the decision, I'd go with Zytiga and save chemotherapy for later.

[Hidden in reply to Hidden]

Hi Gregg57, really appreciate your clear comment. Thank you and wish you the best!

[Tall_Allen]

If he does 6 cycles of chemo now, he can move onto Zytiga in just 15 weeks (after his 6th infusion). Can he still get the free Zytiga in 15 weeks?

[Hidden in reply to Tall_Allen]

Hi Allen, my apology to ask you about the point "By starting with 6 infusions of Taxotere, one is able to use Zytiga after only 15 weeks; but if one starts with Zytiga, it may be 3 years before Taxotere can be tried". I misunderstood it but it's clear for me now. Thank you again!

[Hidden]

Thanks Allen! I have read a number of your posts and one of them provided the link prostatecancer.news/2019/12.... I continued with the link in this article nejm.org/doi/pdf/10.1056/NE..., however, I could not find the info "By starting with 6 infusions of Taxotere, one is able to use Zytiga after only 15 weeks; but if one starts with Zytiga, it may be 3 years before Taxotere can be tried". May you indicate which paragraph or line I can quickly find the above point? Thank you in advance

I will ask the doctor about your suggestion but it is highly likely that my dad can take one of them if it's effective. It means Zytiga can be added only when PSA increases again after chemo.

[Hidden]

Do the chemo NOW. His cancer is on the move. Zytiga suppresses cancer, chemo kills it. Worry about the zytiga cost later, plenty of aid out there to help defray the cost. Don't play with fire.

[Hidden in reply to Hidden]

Thanks Fran2020! We share the same opinion with you and don't want to wait for the treatment.

[Hidden in reply to Hidden]

Then do not wait Dawn. You can get him to a better place. Hopefully the end justifies the means. Good luck .

[Hidden in reply to Hidden]

Thanks Whimpy-p! My dad started chemotherapy last Wednesday.

[Hidden in reply to Hidden]

That’s great.?Keep his spirits up anyway possible . Many prayers for him now🙏

[Maxoscarlady]

My husband takes it for 9 months then off his psa goes to.01 in bout five months on it but dr keeps him on it for 9 months usually stays down for a year this is his second time on it we are not doing chemo til this doesn’t work anymore

[Hidden in reply to Maxoscarlady]

Thank you! Cam you share your husband’s Pca treatment history? Best to you and your husband.

[alsam]

Hi,

I have to agree with Dark Energy statement "Don't let the Prostate Cancer pick up steam'..I am an 8-year advanced metastatic prostate cancer survivor, diagnosed in January 2012 .

My presenting PSA was 509 ng/ml and it is believed that it went up to over 800 ng/ml. After commencing treatment on Abiraterone/Zytiga (March 2012) of 7- 8 months my PSA reduced to less than 0.1 where it as remained to this date without any rises whatsoever...

Now, I am not saying that it's the same for everyone, nor am I saying it works for everyone but for many it as worked, clearly myself included.....Yes there are some side-effects however, I am alive and my condition is managed very well indeed...I trust this may assist you...

Kind Regards,

[Hidden in reply to alsam]

Thank Aslam for your sharing. My dad's T level was very low in April, 0.08nmol/l but his PSA still increased. I understand that Zytiga also reduces T level. So should he use Zytiga right away or chemo is better at this time?

[alsam in reply to Hidden]

I would suggest that is a discussion for the oncologist... Personally speaking I would have thought so though...

[Hidden in reply to alsam]

Dark energy be knowing stuff. I agree. 😎

[alsam]

Hello Dawn80...from a personal perspective I would suggest right away....However, talk with your oncology team ...its very important that you develop that relationship and trust with them also...

[Hidden in reply to alsam]

Hi Alsam, my dad started his chemo treatment last Wednesday. He experiences certain side effects such as fluid retention, fatigue, muscle/bone pains and light fever (37.2 Celsius degree). Thank you again for your advice!

[Hidden in reply to Hidden]

One day at a time sweet Jesus. 🙏

[alsam]

All of these I have undergone....So nothing weird and wonderful there....