After 6 cycles of chemo, PSA nadir touched 0.015 in Jan. PSA crept up to 0.288 in Aug and currently reached 0.667.
Das has been advised to start Xtandi (Enzalutamide) 40mg - 4 pills a day. (2 each after breakfast and dinner). MO apparently believes Xtandi is better than Zytiga for a few reasons.
As I recall from several posts I read here, many have faced severe side effects due to Xtandi like numbness in legs and extreme fatigue, and some either halved their doses or discontinued it.
Is there anything to be cautious about or monitor as we start off Xtandi?
Thanks!!
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That ‘Zytiga May cause elevated blood sugar levels’ which in turn may flare up the cancer. And we have to monitor some blood levels carefully like Potassium’. What do you think? Thank you.
I don't think increased blood sugar has anything to do with prostate cancer progression. It's true that low potassium, high blood pressure, and edema can result if the replacement dose of prednisone is inadequate. But Xtandi comes with its own set of side effects. There is some evidence that the total amount of time in which advanced hormonals are effective may be longer if Zytiga is used first:
I have taken Xtandi (enzalutamide) for more than three years. My recommendation is to take all four pills before bed time. Xtandi does cause some "brain fog" and fatigue. In my opinion it is better to take it at night when you do want to sleep. Hope that helps!
Not in my experience. I take Xtandi about three hours after dinner has been completed. Other than waking up a couple of times per night to take a pee, I sleep very soundly. I was given the choice by my medical oncologist morning or evening as to when I wanted to take Xtandi. I said at night, and I still remember him saying at the time "good choice".
" The most common adverse reactions (≥ 10%) that occurred more frequently
(≥ 2% over placebo) in the XTANDI-treated patients are asthenia/fatigue, back pain, hot flush, constipation, arthralgia, decreased appetite, diarrhea, and hypertension. (6.1) "
On Lupron since Jun 2018. PSA drop from 1300+ to 1.2 range. After 2yrs PSA started rising and more alarming was the reduction in doubling time. Added Xtandi 5mos ago and quickly dropped from 9.1 down to .5 so for ME Xtandi is very effective. SE so far only seems a little more fatigue and a little more brain "fog" and balance loss.
All in all Xtandi is very powerful at lowering MY PSA with minimum disruption to MY QOL.
Ok I was on Xtandi for 19 months before it failed. I was able to retain my commercial pilots license, I had no real side effects to mention. I do stay physically active but who knows. I do understand your concern but hit it head on and see what happens. People who do well very seldom post but in reality I could not tell any difference since I have been on Lupron for years. I really think your underlying health may play a difference plus physical training and being positive. Good Luck , Blue Skies
My dad took it for about 5 months it made him very tired, forgetful, weak and could barely walk. I called the makers of the xtandi and they told me to stop the pills and talk to the doctor but as per usual he hasn’t heard any side effects?????? My father went from being bedridden to now being able to cut his own grass. He is 82 so maybe his age worked against him? Good luck
Fatigue and brain fog/cognitive/memory issues mainly. I’ve also had headaches that I had to address. I take it in the evening around 8:00, I tried taking it during the day and it only made the fatigue worse.
You have been given some good advice here. Zytiga would be better, you have had casodex which is a "ludimide". So is xtandi. Go to Zytiga and save xtandi for later.
If you stay with xtandi take all 4 pills after dinner, any side effects would be tolerated at night.
I believe the labeling for Xtandi says take all 4 pills at once any time of day. I have been on it 2.5 months now. Fatigue and skin changes so far as well as increased loss of sexual desire and function. There comes a time each day when the fatigue comes on very strong.
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