Diagnosed with Stage 4 Metastatic PCa in the end of May

[Pianodude]

Hi, I am new here. I was initially diagnosed 3 1/2 years ago by a urologist with a very small, slow-growing tumor after a fusion biopsy. I was told that there would be 10 other things that would kill me before this caused me any problems. He suggested that I come back in for a biopsy after a couple years just to see that it was still progressing very slowly. My Gleason score was 5. I got busy with life and just forgot about scheduling another biopsy. Back in May a routine blood test for a physical showed my PSA to be 819 and my alkaline phosphatase to be 1702. A biopsy and bone scan in the end of May resulted in a diagnosis of stage 4 metastatic PCa. Extensive mets in my skeleton. I started into treatment a week later with Docetaxel chemo every 3 weeks and Firmagon once per month along with 5 mg prednisone twice per day. I have had 3 chemo treatments and 2 injections of Firmagon. My PSA is now 4.3 and my AP is 302. I was having back pain before treatments that I thought were caused by other things. That pain disappeared after the first treatment. Being new to this, does anyone have any other suggestions for things I should be looking into?

[Tall_Allen]

Your cautionary tale illustrates the importance of having at least two mpMRI-targeted biopsies for men on active surveillance. A good friend of mine also missed his GS9 cancer on his first mpMRI-targeted biopsy.

You seem to be responding well to chemo+ADT. A good next step would be Zytiga. When that fails, which may be after several years, you will be eligible for a lot of different therapies - immunotherapies, radiopharmaceuticals, different kinds of chemo and advanced hormonal therapies. There will be several more options by that time.

[Pianodude in reply to Tall_Allen]

Thank you for your response and the information that you provided.

[Magnus1964]

Good story. I like to hear success story in this fight. You are doing great. If your bone mets return you might look into external beam radiation. If the mets are too scattered for EBR then xofigo would be way to go. Don't forget there are a lot of ADT drugs out there.

Keep up the good fight.

[Hidden]

Darn urologist .

[j-o-h-n]

You played it for her.... now play it for yourself..... Get the best Oncologist you can find and start playing duets with him/her. Ask here if you need a reference to a good Oncologest in or close to your area. Stay with us and keep asking questions and fillling us in on your progress.

You'll be tickling those ivories for many many years. Keep the faith....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 07/28/2020 7:52 PM DST