Confused about treatment options

[Scootman]

I am on Xtandi going into 3 mo and have had 2 psa reading which have gone up. met with one of my oncologists last week and told me that because numbers went up does not mean drug is not doing some good. She suggested that the options she is considering is changing to Zytiga or possibly trying to get me in a phase one trial using a immunotherapy drug and a drug currently used for kidney, bladder and lung cancer do not remember exact name but started with ca something. One of my urologists suggested why not asked to be put on Provenge since it has history and not take a chance with a trial which is has potential but unproven. Can anyone give me any input. My urologist stated the Xtandi is probably doing some good also since my psa went to 12 then 19 considering I have 2 bone lesions on my hip.He said he would have expected the numbers to be higher if the Xtandi was not doing something. So just asking is it unreasonable to ask about the Provenge as the next step. Thank you

[Tall_Allen]

Provenge is particularly a good idea when combined with another therapy, like chemo or Xofigo.

[Scootman]

They did send a tissue sample to foundation one a was told there was not enough of a sample to run the teat.

[Scootman]

Is it wiser to go the Provenge route than participate in a new phase one trial of a immunotherapy drug in combination with a drug used for kidney or bladder cancer. My gut tells me I should ask for the treatment combination that is shown to have a history. Am I thinking incorrectly, just being thrown so much info some which does not seem to make sense to me. But then I am not the expert and always second guessing myself. Also my urologist keeps telling me I am still very treatable but in my mind I keep thinking I am coming to the end of the road which really clouds my judgement. Thanks for your input

[Scootman]

They did use the prostate biopsy sample which they sent out. I spoke in depth last night with oncologist about provenge,xtandi and the trial. He stated I was not eligible for the trial and he had not seen enough success with provenge to use it on me. So I said where do we go from here and he keeps telling me the there are still a lot of options available to.That he wanted to stay the course with the xtandi but do scans more often to see if any new spots show up. I told him would it not make more sense to prevent the new spot instead of waiting for them then acting. He insisted he wants to monitor me and said in about a year we may to do chemotherapy but did not want to put me through that because I am recovering from a broken back.It just seems not to make a lot of sense when he says there are still a lot of options available to me but then says chemotherapy in a year. I guess I am just looking for some sort of encouraging news because I feel like I am getting in a really dark place. Do you know of any documentation where it takes more than a couple of months for the xtandi to work? I have been on it for two months now.

[HopingForTheBest1]

Had Provenge in March 2019, 10 months after initial diagnosis and 5 months after robotic surgery. From what I have read it is more effective the earlier you get it. Keep in mind it doesn't necessarily lower PSA. Make sure your insurance covers this treatment, as it is costly at around $250k. Thankfully, I was fully covered.

Also had genetic tests from Foundation and Color. Both confirmed BRCA2+, and successfully went on to Olaparib PARP.

Nalakrats, who also responded to you, is a great resource on this forum. Take his advice seriously.

[j-o-h-n]

ca... i think you meant Keytruda........ (i'm on it fighting lung melanoma not for my Pca).

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/24/2020 7:56 PM DST

[Scootman]

Pittsburgh Hillman cancer center

[Scootman]

Hillman is where I good this opinion which is my second opinion