Post Docetaxel treatment plan

[GoNapoli]

Happy Holidays to all! Thank you for all your posts, every morning I do my Father's research since he has been diagnosed in May and we learn so much valuable information on this site. My father completed his 6 rounds of Docetaxel and responded really well and tolerated it quite well at 75 years old with the exception of horrible taste changes. With Lupron/Eligard & chemotherapy his PSA went from 680 to 3.0 and his alkaline phos is down to 56, he had to many bone mets to count and the scan showed "significant improvement" post chemo. Unfortunately his PSA has been creeping back up since end of October up to 26 which is creating some anxiety. Next step we are awaiting support approvals for Xtandi (so expensive $$$$), Xgeva injection on the 29th, and Provenge hopefully in January. What are some experiences with those treatments Xtandi and Xgeva? my Dad is overwhelmed with all the literature of side effects. I read alot of posts about Xtandi the good, bad, and ugly, is it better to begin with the 4 pill a day dose or inquire about starting at a lower dose to see side effect response? I know he needs it and I am pushing for a quick approval on the support for this drug. Thanks again to all you great men and Happy Holidays from my father and I in sunny Florida :).

[Magnus1964]

I would do all four xtandi pills at first. If the side effects are not tolerable than ask the doctor if it would be OK to cut back.

[Shooter1 in reply to Magnus1964]

If they are as bad as mine, don't wait to ask Dr. Mine wanted me to stay on high dose but life was not worth living.

[GoNapoli in reply to Shooter1]

Thank you for the reply, I hope they will not be that bad. What are you currently taking in place of Xtandi?

[Shooter1 in reply to GoNapoli]

Still on xtandi but at 80 mg (2 pills at 9 pm) dosage. My body can handle that much.

[Tall_Allen]

I think Xofigo and Provenge is a particularly good combination if used early enough.

[GoNapoli in reply to Tall_Allen]

Thank you for the reply, is Xgeva similar to Xofigo or same concept?

[Tall_Allen in reply to GoNapoli]

No, completely different. Xgeva helps maintain his bone mineral density. It isn't a cancer therapy - it just prevents osteoporosis, which can be caused by ADT.

Xofigo (Ra-223) kills cancer cells in the bones.

[GoNapoli in reply to Tall_Allen]

Ok got it, so some men out there do Xofigo, and provenge, on top of the Xtandi?

[Tall_Allen in reply to GoNapoli]

No, not on top of Xtandi. There is a clinical trial now combining Xofigo and Xtandi and Xgeva (but not Provenge). A similar clinical trial combining Xofigo and Zytiga was stopped early because there were many bone fractures. They hope that by requiring Xgeva (or Zometa) they can prevent the excess bone fractures that might otherwise result from combining Xofiga and Xtandi. But that remains to be proven, and should not be attempted outside of a clinical trial. Anecdotally, my friend insisted on combining Xofigo and Nubeqa and Xgeva and suffered crippling spinal compression, requiring surgery and rehab. He never recovered from it.

[dhccpa]

Some doctors are recommending Zytiga at 1/4 the original dose with a meal instead of full dose on empty stomach. Not universally accepted but allowed. I don't know if that applies to Xtandi.

[bloodyveinpoke]

If you use "goNapoli" and are in "sunny Florida" I have to think you may be in Naples?? We lived there for 47 years, just recently moving to Tallahassee. Have to say that my Naples docs missed a couple of signs which may have made a difference in my treatments and outcome, but that is water down the Gordon River. It is a rough ride, for many of us, and looks like I will start hospice in a month or so after giving the PCa another fight. ;-( Best wishes to you and your Dad.