Castrate resistant

[Fight11]

Why is castrate resistant such a game changer? I know that Lupron is not working as it should. Aren’t there some line of drugs that work? Does it really cut your life expectancy?

[Magnus1964]

If you have not received casodex, zytiga, xtandi, etc, your a long way from being castrate resistant.

[noahware]

Becoming CR means one's cancer has evolved and adapted to be able to thrive and grow under conditions (super-low-T/no-T) where it formerly struggled. So while the treatment-game begins as "look at how easy it is to slow" the game changes into "oh, all the low-hanging fruit is gone." The REAL challenge begins.

One has to remember that the ADT treatments were never really curative in the first place, but were very effective ways to DELAY progression and relieve pain and other symptoms. Yes, there are other drugs that can and do work after becoming CR, but they are also playing the "stall-for-more-time" game.

Unfortunately, being metastatic means that THAT is the game: keep on stalling. With any luck, we find enough new ability to stall and re-stall and get to keep kicking the can until we are lucky enough to get into our eighties or nineties and die of causes totally unrelated to PC (and hopefully unrelated to treatments).

The variation in how different individuals responds to the stalling game is of course huge. Some only get months, but some get decades!

[LearnAll in reply to noahware]

Very true...Some can stall the growth of PCa for decades with all kind of different hurdles placed in its path. I like the way you expressed the facts .

[Tall_Allen]

Castration resistance marks a genomic change in the cancer where it becomes active even without testosterone. Fortunately, there are several medications that are effective even after castration resistance.

What was the result of his biopsy?

[Fight11 in reply to Tall_Allen]

They said he is a Gleason score nine group 4 and he has a CDK 12 mutation. He is on Zytiga right now along with prednisone even being on that he has a lump on his neck which just developed two weeks ago. They are going to do a CAT scan of the neck abdomen and chest and pelvis as well as a bone scan. I don’t think the Zytiga is working quick enough his PSA has drop some but I think the cancer is working faster than the Zytiga