Good Morning Shipmates, I need some advice. I started on Lupron in Jan 2019 and reached a PSA nadir of 0.9 ng/dl in June 2019. Since then my PSA doubling time has been ~ 2.5 months.
My PSA is now 86 ng/dl and my Total T is 6.0ng/dl.
Yesterday I had an MRI and I have mets on my spine and suspicious adenomegaly in neck and abdomen. No mets in organs. CEA, LDH, AlkPhos all in normal range. This lab work was ordered by my Urologist, who upon seeing it recommended continuing on Lupron and adding Zytiga. He also recommends laser ablation of my prostate to deal with frequent urinations which recently have become slightly painful and sometimes bloody.
I am totally on board with the prostate ablation. But I question the Zytiga. My urologist was not encouraging about seeing an oncologist, but I am making an appointment with an oncologist today. From what I have read It seems that Docetaxel would be a better choice. Any advice on this matter would be greatly appreciated.
FYI, I live in Mexico and cannot access healthcare in USA..
Thanks, Have a Great day
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Frigataflyer
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If you choose just one, the important issue is side effects. In which case I would lead with Zytiga if you have been doing well with lupron.
Welcome aboard ! Straight thinking Capitan! I’m sorry about these Metz. You must Believe that you can knock them down . My uro gave me a plan , but then he got a specialist involved that chose another path. The uro said chemo six months and id die in 36 months no matter what I did. The specialist put me on a test adt drug that I’m still on today and Lupron of which I halted by an orchiectomy . No more shots. I take four pink pills a day , That was over five years ago . Viva Mexico ! May o’ mighty God Bless you with a cure and many years of happiness beyond this dx. 🙏🌵
I just got a Lupron shot Yesterday, but if I can eliminate that expense three months from now with an orchiectomy, that will be the route I follow. Provided the urologist can actually find any testicles to remove.
My pc specialist had me wait for one year before doing an orchiectomy . As he said to be sure. I went into remission and was given the green light. Off with los juevos. You will need more than just three months Of adt in my thinking. But if and or when you think you want an orch remember that you will not get t again withOut having it injected . We all want
To feel that t again . For many advanced cases it isn’t in the cards. After one year of adt you will hopefully have no PSA and you will be chemically castrated by then anyway . My boys were tiny and a bit painful. For me it was like trimming dead wood from a tree. They told me I’d be on adt for life. Thus the orch. No balls but I still get nightwood every night.Go figure? I much Prefer limes to lemons. I was surprised never to see a lemon in o Mexico . They don’t exist do they? Met wife in Cabo and I ve travelled a bit in that pais bonito . Buenas Suerte Senor!
Chemo kills cancer cells, Zytiga holds them in check. Have your new oncologist get you started on Docetaxel and keep Zytiga in your back pocket. Chemo side effects aren't half as bad as people make it out to be.
In my opinion, as someone who has already been down your road (or sailed your seas, not sure which) Yes to prostate ablation. Yes to switching from a urologist to an oncologist. Docetaxol probably a good idea, although I have personally never been on chemotherapy. Zytiga (abiraterone) and Xtandi (enzalutamide) are the Pepsi and Coke of second tier hormonal drugs. If you don't like the idea of Zytiga, consider Xtandi but choose wisely! I have been on Xtandi for close to three years with fortunately few serious side effects. Both have their supporters and their detractors. No question, there are side effects with both but no need to take Prednisone with Xtandi. Hope that helps.
Forgot to mention, stay on Lupron! Prostate cancer cells are heterogenous and because your cancer has escaped the prostate the different types are moving freely. Lupron is still working on some cells. If you drop Lupron, you are back to square one. Hope that helps.
I doubt it. Plus you’ll still have an Adam’s apple. That and a deep singing voice are amongst the few male attributes that I have still. Oh and the Anger.😂In five more I’ll see? I know I lost 15% bone density my first years. Then 5 % each year there after . Hope is prolia can’t slow that roll . TGIT
Either docetaxel or abiraterone or enzalutamide are good choices. Docetaxel may be more tolerable sooner rather than later. Xofigo is a good option too if available there. Definitely, see an oncologist who specializes in urinary cancers.
The British NHS decision seems to be based on Abiraterone’s costs more than effectiveness, since the article says they couldn’t get the manufacturer to agree on the pricing. Docetaxel appears equally beneficial to abi in trials, so it’s a matter of whether you can tolerate the side effects.
I've been on Zytiga almost three years along with six month Eligard injection. All of our options unfortunately have quality of life side effects and each one of us is different in our Cancers.. You need to find a good oncologist that you are able to be comfortable with making the choices with you. The side effects for Zytiga are tolerable definitely life style changer but tolerable. I've also had Provenge immunotherapy infusions around a year ago . Never give up never surrender. Leo
Thanks to all who posted in response to my query about “Docetaxel vs Zytiga”. The combined thinking of this group is my beacon through these turbulent waters (might as well continue the maritime theme). Zytiga is financially out of the question and I had already psyched my self up 99% to set a course towards docetaxel. Today, I am going forth to get a preop checkup before my focussed laser ablation and in parallel am looking for an oncólogo to supervise the Docetaxel. Thanks again. Will undoubtedly be back to you on this one as preliminary Inquiries suggest there is no local on oncólogo who specializes in urinary cancers.
Buenas días Frigataflyer, también vivo en México y he recibido tratamiento para mi cáncer aquí por 2 anos. Me gusta mucho para contactarte con tu correo privado si es posible para comparar nuestros casos.
I'm Canadian living here for 12yrs. Please send me your email address so we can chat further, cheers.
I've started (09/2018) with Casodex for two weeks, then Lupron and Zytiga to date. But, also "added" Taxotere (Docetaxel), last infusion was at (11/2019). So, Lupron, Zytiga and Taxotere all on the same time, the idea is too hit it hard early!
Definitely see a medical oncologist and a radiation oncologist if you haven’t. I did zytiga first and it was good for me for a year. Later I did the docetaxel, it was really hard on my body and didn’t work very well.
I agree with seeing an oncologist soon. When I was diagnosed, the oncologist said I could do either docetaxel or abiraterone to start with my ADT. Both she and I agreed to do the chemo first. We both thought I could handle the side effects of chemo best early on when my body was at its strongest. We would keep the abiraterone as a future weapon when needed. For the record, chemo was not fun but it was not nearly as bad as I expected. Best of luck to you. Let us know how it goes.
My father had the same choice and went with Docetaxel first before the Zytiga. That was definitely the best option for him because the cancer was significantly beaten down from the chemo. It was not overly pleasant for him, but not overly unpleasant either. He knew a couple
of days after the infusion he would feel “hungover”, but with the right attitude and exercise he managed it. Imho, first go with the Docetaxel. I hope it kicks the cancer’s butt for you!!!!!!!
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Yes to prostate ablation. Yes to switching from a urologist to an oncologist. Docetaxol probably a good idea, although I have personally never been on chemotherapy. Zytiga (abiraterone) and Xtandi (enzalutamide) are the Pepsi and Coke of second tier hormonal drugs. If you don't like the idea of Zytiga, consider Xtandi but choose wisely! I have been on Xtandi for close to three years with fortunately few serious side effects. Both have their supporters and their detractors. No question, there are side effects with both but no need to take Prednisone with Xtandi. Hope that helps.
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Docetaxel or not?
