Well, I think it's important to determine if you are detectably metastatic before deciding on a treatment. If the spot on your pubic bone did not shrink with Zoladex, it is most likely not a metastasis.
Xtandi (enzalutamide) works. At least it has for me. I have been on it for over three years. My medical oncologist's advice would be to stay on the Zoladex train and simply add Xtandi to it. Hope that helps!
You could request an Axumin PET/CT scan to determine if the lesion in the pubic bone is cancer and if there are other metastases.
If the pubic bone lesion is not a metastasis and there are not other metastases , you could qualify for darolutamide which is effective and better tolerated than enzalutamide or apalutamide.
The scan could also determine if there is activity in the prostate or in the pelvic lymph nodes and you could discuss if some local treatment could be indicated.
I've had several Axumin Scans showing one spot near where my prostate was, but when I had surgery to possibly remove the cancerous lymph node, pathology found no trace of cancer there. I also had several Mayo clinic C-choline 11 scans that showed the same possible cancerous spot. So my conclusion is these so called sensitive scans For prostate cancer are bogus and a waste of money and time. I did the scans with the hope of finding oligometastatic cancer that could be removed thus being curative.
Sorry to hear these PET/CTs did not work for you. They did work for me and in fact work very well for most of the patients according to the clinical studies,
Bad news pal, but like me, you got so many years since the start of the war, so feel very blessed, as so many men do not get the time we have had. You should not give up but the fact is, as of this date, lots of stuff in the pipeline, but most offer short term benefits.
I suggest you make up a bucket list and go pedal to the metal-in all senses, live LARGE, love lots and fill up your remaining days. I too am getting ready for the last stage, and this damn virus has totally screwed up my plan to race my drag car as much as I could. such is life boys, rock on all!!!
Dad was on Zytiga (Abiraterone) which is similar, both this one and Enzalutamide can cause extreme fatigue.
Enzalutamide usually works for 2-3 years I think, but considering you got such an amazingly long response to Zoladex, you have a good chance of squeezing a lot more time than the average on Enza.
Every hormonal drug usually works for less time than the previous.
Wow 23y, all of them winners I'm sure, with your staging and Gl score. Great. I would go to some effort to determine the ? metastasis in the pelvis. Could be a spot weld (SABR) might do the trick, +/- systemic treatment such as Enzalutamide.
I was on Zoladex for 6 Years, then Oncologist told me i am Zoladex resistant now.. put me on Xtandi and Firmagon.. made a huge difference to the PSA.. but many more side effects..
I have been on intermittent hormone therapy for 17 years. PSA low as less than .002 to high of 72 depending if I'm on or off. No surgeries, no radiation. Initial psa of 14, 8 out of 12 cores positive, gleason 7(3+4). Hormone therapy has kept it under control but it has spread some. I'm 70 now. Started intermittent xtandi 5 years ago. It is approved for stand alone therapy if u want to dump the zoladex. Lowest psa on xtandi was 0.98. I think it would have went lower but I had a thyroid storm and heart issues for several months ...long story. Back on a cycle again. Psa 2.2 and dropping. No bone mets yet. Xtandi side effects not bad for me. I exercise and it helps. I can also get erection with xtandi alone. Wife and I still have fun date nights. Docs want me to add something that would probably ruin that. No thank you.
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