Zytiga: Can Zytiga shrink bone Mets... - Advanced Prostate...

Advanced Prostate Cancer
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Can Zytiga shrink bone Mets? How long is Zytiga usually good for months a couple years? Have any of you had good results with it? My husband starts it on Monday!!! Lupron is working psa is rising he is a Gleason 9 with some mets

83 Replies

I was on zytiga for over 3 years. It can work on bone mets.

Manohar11 in reply to Magnus1964

Can it help to keep the psa down. Does it shrink the bone Mets

It shrinks bone metastases and reduces PSA, and most importantly, extends life. Median time to failure for a man newly diagnosed is about 3 years.

Hi, exactly 2 years ago I was diagnosed with G9, stage 3 and no mets.

Started Lupron immediately and Zytiga on 4/19 (just after HDR brachy and before 25 weeks of IMRT).

Within a month after starting Zytiga my PSA plummeted. Here is my history:

On 5/2 /18, I was at 25.2. After Lupron I went to .162 and the month after I started Zytiga, I reached my nadir of <0.014 and have held steady since 4/19.

Prostate Specific Antigen, Total

<=4.000 ng/mL

25.200, 28.1 //13.49,18, .162// 0.014<0.014<0.014<0.014<0.014<0.014<0.014<0.014<0.014<0.014<0.014<0.014

I realize that I really haven't answered your question (since I'm met less.)

Just want to plant a forum "seed" and open this up for further discussion.

Best wishes and keep the faith!


Was there but opted for Xtandi, Never will know if zytiga would have been a better choice. Best of luck to you, 3 years into xtandi. Bone mets and lymph nodes disappeared.

Manohar11 in reply to Shooter1

How are you at this point

Shooter1 in reply to Manohar11

Remission with PSA of 0.1 On 1/2 dose xtandi (80 mg)

Hi Shooter:

I am about to start Xtandi in addition to my Lupron. PSA rising to 1.8. Did you have additional side effects from the addition of Xtandi?

Congratulations on your success.


Biggest side effect from Xtandi, for me, is fatigue. Most take in evening or before bedtime. Next month I will have been on Xtandi for 3 years after my initial 8 cycles of chemo. Psa is now <0.1 Have switched to Xgeva and blood test every 3 months. (On Lupron of course, every 6 months.) I have extensive bone mets, lymph node mets no longer visible. Last bone scan on July 10, 2020 Impression:" Stable whole-body bone scan." The mets are still there, but there has been no significant change and no new mets. Pushing the envelope now. Best of wishes to you. Monte

Thanks Monte

You had eight cycles of chemo. How bad was that.

What is x g e v a

Thanks Tom

Chemo was not all that bad. It's usually 6 cycles, so that is 18 weeks. You are ok 1st week, feeling crappy 2nd week, and coming back up to normal 3rd week. At the end of 8 cycles I was feeling crappy for 2 weeks. And then it was over. Probably need Neulasta or similar for white blood count. Xgeva is for bones. Injection in the belly fat. Easier than a blood test. Just a prick. Kinda like j-o-h-n.

j-o-h-n in reply to monte1111


Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/26/2020 6:42 PM DST

With Xtandi full dose I became a complete invalid. Numb face, hands, butt, feet, no balance, couldn't feed myself, etc. Not good. Cut dose three times---120, 100, 86 mgs, and was able to return to work and 3 1/2 mo. later retire. Ended up with the 80 mg dose which I can live with but have lasting neuropathy in hands and feet. The new normal isn't like the old normal where I felt like I would never get old and would always be a strong mountain man. Darn turned into a 70 year old man. and I'm only 70. Guess mAPC will do that to you.

Yes but your PSA is undetectable.

True, and I am still here years after the Drs first told me I was dying.

How long have you had the beast

Only 3 1/2 years from surgery with horrible pathology report and 12 mo. estament for survival.

Manohar11 in reply to Shooter1

How are you now? What is your psa ? Are you still on the Xtandi

Shooter1 in reply to Manohar11

Getting by. Finally able to balance my bike. Last 2 yrs 80 mg (2 pills at bedtime). PSA has varied from 0.13 to 0.00 over last 2 years. Last test 0.10.

Manohar11 in reply to Shooter1

Did you have mets and castrate resistant?

Shooter1 in reply to Manohar11

Yes. Mets in lymph nodes and 5 in bones. All disappeared now on scans, still hormone sensitive but orchiectomy takes care of T, so no lupron.

Manohar11 in reply to Shooter1

What is Orchiectomy? Are you castrate resistant?

Shooter that is fantastic. I really don't know whether I should start zatiga or Xtandi I will wait till I get home and talk to my OC

Zytiga has kept my PSA undetectable for 2 years so far. My doctor said he's had patients go up to 6 years on it.

6357axbz in reply to gregg57

Gregg, did you ever consider having your bone mets zapped or are they too numerous?

gregg57 in reply to 6357axbz

Too numerous for sure. My bone scan looked like a christmas tree.

Manohar11 in reply to gregg57

What are they doing for you Gregg

gregg57 in reply to Manohar11

Just staying on ADT and Zytiga as long as I can. My second bone scan looked much better than the first so I suspect there has been some healing. I've already done chemo although when Zytiga stops working I'll go back to it.

ctflatlander in reply to gregg57

Gregg, At what PSA level would you feel its right to proceed with chemo? Bob

gregg57 in reply to ctflatlander

PSA is only one indication and we should wait to see progression on imaging before we change or add treatments. PSA becomes less useful in more advanced PCa.

Doing early chemo at diagnosis is different.

6357axbz in reply to gregg57

So happy to hear your still enjoying the dream!

gregg57 in reply to 6357axbz

Thanks. Yes, still enjoying the dream. Got to hold my brand new grandchild.

6357axbz in reply to gregg57

so sweet!

Manohar11 in reply to 6357axbz



My dad was on Zytiga for five years, it cleared his bone mets and brought his PSA to undetectable for four years. He had no bad side effects from it, other than losing lots of muscle mass - he didn't work out, which would have countered the muscle loss.


Been on Zytiga for over 2 years. PSA was at 800, now undetectable. My body scan looked like a Christmas Tree. Went from getting blood to stay alive to enjoying life, including a nice bowl of chocolate ice cream now and then

GoBucks in reply to lincolnj8

Get some hot fudge too. L'chaim!

j-o-h-n in reply to GoBucks

and the whipped cream........

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/25/2020 12:32 PM DST

lincolnj8 in reply to GoBucks

Oh yes..

Here’s the good news. I’ve been on Zytiga for nearly 9 years. PSA @ dx was 571, multiple major bone Mets to skull, shoulder, two ribs, pelvis and both femurs, plus pelvic lymph node involvement. PSA dropped to immeasurable within 12 weeks where it’s stayed. I think I might be a super responder.

Manohar11 in reply to TommyTV


Your prostate removed

TommyTV in reply to Manohar11

No, still festering away inside me!

Jawbreaker in reply to TommyTV

Sounds excellent - good luck

monte1111 in reply to TommyTV

That's what we all like to hear. Note to myself: "Watch more TV."

pwallace in reply to TommyTV

wow! with lupron right? any other drugs? amazing.

TommyTV in reply to pwallace

Just 3 monthly Zoladex and 5mg Prednisone daily. No dietary changes or ‘alternative’ therapies (which I don’t believe in anyway), alcohol as and when required.

Manohar11 in reply to TommyTV

Are you castrate resistant. My husbands psa was still rising on Lupron

I'm also Gleason 9. Only treatments lupron and zytiga. Just over 2 years psa from over 1200 went down to 0.08. At 18 months a bone scan showed reduction in mets. Only added prolia for bone strength. Wishing him Best of luck with it.

Manohar11 in reply to michael00

How much prednisone you on

michael00 in reply to Manohar11

5 mg twice daily

Manohar11 in reply to michael00

Are you castrate resistant my husbands psa is still rising while on Lupron

michael00 in reply to Manohar11

Doc refers to me as castrate sensitive but not resistant.

Manohar11 in reply to michael00

What is the difference?

michael00 in reply to Manohar11

I'm not really sure. I believe it just means responding to hormone therapy. I see him today and will ask

Manohar11 in reply to michael00

Could you please and let me know !! Thank you so much

michael00 in reply to Manohar11

Oncologist did say i was correct that castrate sensitive is a term they use specifying not yet resistant, still responding to ADT.

I've been on Zytiga going on three years now PSA has been at 0.1 since first month treatment. I think the combination of six month Eligard injection has been a good combination for me. I am not saying it's a wonder drug but has worked wonders or me. The draw backs are it's lifestyle changing side effects hot flashes, loss of libido, weight gain, fluid retention to name a few. It's not as bad as the alternative. Never give up never surrender. Leo

Manohar11 in reply to leo2634

Are you castrate resistant my husbands psa is still rising while on Lupron so they are also putting him on Zytiga

Zytiga worked for about 8 months for me. Did improve bone mets and dropped PSA from250 to7. Unfortunately now my PSA has starting rising again and its on to next treatment.

What will you be trying now

Looks like a combination of chemo plus radiation. Radiation on a couple of large bone mets.

How long have you been castrate resistant

Two months.

Praying all works out!!! 🙏🙏🙏

Thank you. Need all the help I can get.

Zytiga/Prednisone lasted just 6 months for me. Based on genetic testing and precision medicine, I went on to Olaparib. PSA undetectable for 14 months so far.

Where do you go for treatment

Rutgers Cancer Institute of NJ.

I’ve been on it 5 1/2 yrs. plus Prednisone and Trelstar. PSA has remained at .008 . Next blood test in Sep and keep hoping for best. 🙏🏻

Hi have Mets to pelvic nodes l4 t5 left rib both illiacs pelvis right lung 22nd Dec 2017 diagnosed put on firmagon then in Feb 2018 zytiga added unfortunately zytiga stopped after 2 weeks severe reaction to it put on various supplements including two pda last month under1 has been dropping slowly scince diagnosed from 464 Olney slight rise twice but drops again following month have had no chemo no radiation stiĺ have a prostrate have problems with monthly firmagon injections inflamed injection site plus flue like symptoms every time decided to take a break from it havnt used it for 5 months t .56 now but psa remains under 1 scans report no Mets they are thinking now l4 and t5 could be scars from Mets still waiting for pmsa scan over a year now not sure where to go from here best of luck everyone

I've been on it for a year, and so far, so good.

However, I did end up getting radiation on my spine due to mets, and though it was not a fun experience the results were incredible--totally eliminated my pain! After the radiation my PSA also dropped, another plus.

oilcan4 in reply to NEHOG

My husband had spot radiation on spine for bone pain. How long before you got relief from pain. He still has pain and it has been 4 weeks.

Similar to my many comrades' experience, Zytiga shrunk my bone metastasis resulting in a lowered PSA. My oncologist placed me on ADT three months after my RP surgery in May 2017 after my PSA and cancer continued to increase. Starting in late August 2017, I was placed on Casodex & Lupron, which was followed by Zytiga and prednisone two weeks later, Casodex was then stopped. Within four months, PSA was down to 0.4 and bone metastasis shrinking. In March, 2018 Xgeva added to the mix. There was a slight uptick of my PSA in October 2018 due to activity on a small area of my T-9, which was zapped. PSA returned to 0.5 and back pain disappeared. Nearly two years to the day after starting ADT, chemical failure occurred in August 2019. Over the two year period, side-effects included loss of muscle mass, fatigue (noticeably fluctuated between injections), and pain. To help offset side-effects, I ate healthy and exercised (rowing, yoga, and weight-lifting), continued to work, and kept in correspondence with friends and family. Medical marijuana helped with pain. During ADT, my exercise routine and work schedule less than before my cancer dx due to my loss of strength and stamina. Men on ADT experience a wide range of side-effects, for some men, no real change, others much more so. Wishing you and your husband success and perseverance, it can be a roller-coaster of a journey.

My husband was on it for 6 months and his PSA was inching up. It did help some with the bone mets. He then took xtandi and same thing occurred. He is now to start chemo

Best of wishes to you both. Hope the Zytiga works well. Looks like you still have chemo in your back pocket.

My husband was diagnosed May 2019 with PC Gleason 10 and 8 mets to mostly bones (one lymph node), and went on hormone therapy first, then we added Zytiga. Zytiga didn’t seem to add any side effects at all, and our last bone and body scans (June this year) showed ‘normalisation of some of his bone mets and the rest were stable). It was too late for us to entertain surgery in our plans. The only bad thing about Zytiga is the price and size (my husband calls them the horse’s breakfast).


Welcome to the forum. The best source for that question is from an experienced Oncologist dealing with advanced PC patients. But from us posters you can get some up great up close and personal stories like mine., and others here. I am GL7 with four detectable bone mets. Zytiga knocked my PSA down to undetectable, and others here to undetectable or "doramntcy" (PC still there but quiet) within two months of starting on it in 2014, I am now on month 68 of <0.014. Shrinking bone mets, possibly slightly in my four spots, but there are probably metastasis in unknown places. Unfortunately it does not work as well for some others, so like Tall Allen cites,the overall picture is still good, in many many cases. Encourage your hubby, and keep us posted!

Wings aka Dan in So Cal

Hi Manohar11,

If your husband's Psa is rising while he is on ADT with monthly or 3 monthly injections, then it may not be working. But usually ADT begins to suppress the speed of the Psa rise soon after it is begun. I had Gleason 9, Psa 6, in 2009, and RP could not be done. I began ADT in 2010 and Psa went from 8 to 0.08 in 8 months, and I had EBRT during 2 years after start of ADT. I paused ADT at end of 2 years, to see if that treatment had worked and Psa was back to 8 in 6 months, so I re-started ADT, and Psa nose dived to 0.2, and then very slowly increased over next 4 years to about 1.0, and then it began to increase faster to 5 in 4 months, and this is typical ADT success followed by failure.

I had my first PsMa scan and this showed the first 2 mets just big enough to make an image, and docs worried Pca might spread locally from PG, which had not been removed, and which was not at all free of Pca despite 70Grey of EBRT.

So in 2016 I had 31Grey additional IMRT to PG, and had Cosadex added to ADT, and that reduced Psa to low point of 0.4, but Psa rose again and so the added Casodex gave me 6 months of Psa suppression plus some suppression of the speed of growth of mets.

So in 2017 rose again to about 6, and next PsMa scan showed many more lymph node mets and bone mets.

I began Zytiga, and it kept Psa down to 2 for about 2 months, then flat lined for awhile, but after 8 months Psa was up again and rising fast and I had the median amount of time suppression for both of these "suppression" drugs. Pca in scans was seen to increase.

So despite Psa suppression, Pca keeps growing, but more slowly.

When Psa reached 12 in 2018, I had some chemo which was next step to be tried in the normal protocol of Pca treatment here. But after 5 infusions, Docetaxel allowed Psa to rise to 50, and it was deemed to be a failure, and not worth continuing.

I began Lu177 in November 2019, and Psa at 25, and my May 2020. Psa was at 1.7 after 4 infusions of Lu177, and after I began Xtandi in April 2019.

Follow-up PsMa scan last August sowed no soft tissue mets and some bone mets were healing. Psa kept going lower to low point of 0.32 last November 2019, a year after first Lu177 shot.

But since then, Xtandi has probably stopped working, and Psa is rising and it was 30 at 2 weeks ago and my 7th PsMa scan showed some new bone mets and some continuing activity in previously reduced bone mets. So my PsMa scan resembled a picture of a Dalmation dog, with black spots everywhere, again.

But nothing in any lymph nodes or organs. Where the previous PsMa scan showed healing bone mets with no activity, there was no recurrence of Pca. So it seems that Lu177 does work well, but for me, I thought that having 4 shots over 6 months was not going to be enough, and it was not.

Last Friday I had another shot of Lu177, and now docs wait and see what Psa will do.

Its highly possible that Pca will show a moderate decline at least, but I am continuing with Xtandi because docs say that although it is not reducing Psa it may be making my Pca express more PsMa which is the chemical that occurs on the exterior membrane of Pca cells, and which then bonds to a chemical which also bonds to Lu177, which gives Beta particle radiation over short distance, 1.5mm, thus killing Pca at mets but not affecting most healthy tissue.

I have also begun taking Veronda, aka Idronosil, which experts say also increase PsMa expression.

The Xtandi and Veyonda are thought to make my Lu177 much more effective than if I had Lu177 without the added drugs.

Veyonda is a drug that is yet to gain approval but there's so much clinical success its worth trialing. Its an inconvenient drug because it is a suppository, because a man has to take each tablet shaped like a bullet by pushing it up his anus twice a day. But a man should get quite used to that. Drugs are either taken by mouth, injected, or up the rear end, and in fact the rear end way is often the best, because the drug is in a smaller and cheaper amount and far less affected by digestive process. Few men ever would want to inject a drug with a syringe into a vein, twice daily.

Anyway, Veyonda is hideously expensive, but being given to me for free because I have agreed to take it experimentally and I am in a part of an unofficial trial, ie, I have begun to be a laboratory rat for awhile. I only have to take Veyonda for 2 weeks, and so far there are no side effects. I will have side effect of a dry mouth from getting more Lu177. But previous 4 shots last year caused only temporary reduction of saliva and only at night or when I rode a bicycle.

The PsMa scans I have had plus an FDG PET scan a month ago show no Pca that would not respond to Lu177. However, I am getting genomic analysis done soon and maybe have added PARP inhibitor added to my treatment.

Now all this time during last 10 years since diagnosis I have cycled an average of 200km a week on a road bike and at good speed, and my weight is 77Kg, Height 1.85M so BMI = 22.5, and waist = 92cm, and resting heart rate as I type to you = 48bpm. Docs at local hospital say I am healthiest stage 4 cancer patient they have, with no additional heath problems apart from some Pca which remains under control, and which is not affecting my QOL or causing any pain. My fitness level at 73 is better than 95% of other 73 yo men who have had zero problems with Pca, and who have a full amount of testosterone. So I am proving to all that a man does not need testosterone if he spends enough time doing Hard Exercise for 10+ hours a week. I may have felt sad about a few things in life, but not depressed or angry. I cope well without a partner, and very little support from anyone else. I enjoy a few friends, and keep busy in my back yard crafting shed.

My story is what happened to me, and may be different to any other man's story.

In 2012, my oncologist told me there is no cure for Pca, but I'm still here, and doing fairly well, all things considered.

Patrick Turner.

Here's to the rats. Best of wishes.

How long have you been going through this the PSA rising and falling has it been a long time

Since 2009.

Patrick Turner.

Are you castrate resistant with Mets

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