Good morning Warriors:
My MO added Zytiga and Prednisone , in addition to Eligard, to my fight on November 7th when my PSA hit 4.5. My next PSA on December 6th was 7.8 and my PSA from yesterday, 12/29, was 10.1. Obviously freaked out - been fighting this beast for 18 years. Feel great - no noticeable side effects other than hot flashes that are tolerable. Does this mean the Zytiga is NOT working. Love to hear your thoughts.
Thank you.
The numbers suggest it may not be working - but I say that from a purely anecdotal opinion.
A scan at this point would be the best judge of tumor progression.
Thanks so much for your input.Appreciate your help
I know little compared to the smart folks who will hopefully answer later. It seems 7 weeks is not a long time to try something. Your question while perfectly fine here should be directed to your MO. If your MO is not part of a Center of Excellence(or even if so) it may be time for a 2nd set of eyes.
Thanks so much go bucksMy MO is at Mayo Phoenix and I did this PSA on my own outside of the Mayo clinic just because I was so curious. I see him next week and have another PSA thank you so much for your input
You can discuss switching to dexamethasone. A bone scan/CT will tell you if there is any real progression.
Thanks so much ta. I have scans coming up in a couple weeks. My last scans three months ago showed only marginal growth of my bone mets and thank God I have no soft tissue mets. Is dexamethasone like xytiga.Always appreciate your very
Frank input your knowledge is amazing.
Thank you
Sorry, I should have explained. Dexamethasone is a corticosteroid that would be taken instead of prednisone. It replaces what Zytiga takes away. It is taken with Zytiga.
Oh thanks - do you think that would increase the efficiency of the Zytiga?
Is there a reason to do a bone scan or CT scan for bone mets if you can do a PET scan instead?
Idohaveabout8visiblebonemets.Had them for3years. Scheduledfor CT and bone scan in 2 weeks.Thanks so much.
The reason is to track progression. Bone scan/CT are cheap, so it is a better tracking tool. If you were to switch from a bone scan/CT to a PET/CT scan in midstream, is the increase in metastases due to progression or a more sensitive scan?
Thanks I've had them all at least twice, including one Pet Bone Scan and two (most recent) Axumin Pet scans. So any advantage at all now to bone scan or CT scan?
You have a scan to potentially change treatment. I have no idea what you had before or after each treatment, so I can't comment.
Lupron only since the beginning. All scans have been simply monitoring.
Then why did you have the scans? PSA progression? Symptoms?
It was never explained at each stage, but at one point I was being assessed as a candidate for radiation. That RO ran two CTs, an MRI, and then a PET bone scan. A year later je ran an Axumin PET. Then my PSA rose this past summer and my local MO ran another Axumin. However, PSA soon dropped in half back to where it was.
My original question was simply why run a CT or a bone scan if you can run a PET (assume your carrier will pay, as mine always have)?
It's not a general question - it may be a good idea for you b/c you have baselines, but a bad idea for someone else. I wonder if your insurance will refuse to pay for more Axumin - be sure to get pre-authorization.
Hi TAWhat is axumim?
Thanks
The article explains the different types
Oh yes--pre-authorization is a must. Recently my doc's medical center failed to renew a pre-authorization for an Xgeva shot and they had to eat the cost.
As for Axumin Pet, Florida Blue Cross only paid $3,500 for the last one. I'll be on Medicare for the next one.
I am on regular Medicare and a great secondary insurance. Why should I ask for a pet scan I don't know anything about itThanks so much
I have never asked for a particular scan at a particular time. The docs do that. They usually don't say why. I would say, though, that most seem to feel a PET is most accurate for assessing bone mets. That's my impression.
I don't know what other drugs you have been on but it may be time to switch to xtandi.
Nothing but Eligard until November 7 when added Zytiga.Thanks Magnus
I'm in a similar situation, the Radium223 stopped working after 4 rounds and my PSA jumped from 0.028 to 300, slowly at first then pretty fast once it hit 130, I had a PET scan which showed progression in Spine, Hips and Femurs, the pain was also increasing, Oncologist switched me to Zytiga start of Oct and within a few weeks the pain reduced and my PSA dropped down to 88, it was also the first time I had any pain relief since diagnosed 2 years ago. My Dec appointment now shows PSA increasing, now at 110 and pain levels have increased as well, it's very up/down, one moment the pain is so bad I can hardly walk then a week later it's almost gone, only to repeat the cycle of pain.
I'll see my Oncologist in 3 weeks, I hope he has a solution to get my PSA back under control. Having no experience in this situation I'm not sure what this means for me. How many options I have left and if they keep failing they way they are at the moment, how much time do I have before this cancer takes over completely, it always seems to find a way around my treatments.
The only thing he did was double the Prednisone to 20mg when I said the pain and fatigue was bad.
Wow - Good luck - please keep us posted.Thanks
I would stay on Zytiga a bit longer. I would add Avodart.
Ok - what does avodart do???
I’d also like to know the benefit of adding avodart to zytiga, hubby current takes Flomax and zytiga.
Do u take supplements? If u don't do u want too? It's all anacdotal. If they move u to Xtandi u usually get to drop the steroid.
Hi Kevinski:No I do not take supplements..
The thing that confuses me is I I only have some hot flashes from the Eligard - no bad effects from the Zytiga and predisone. Still feel great - exercise, lift weights, walk and play golf. Not as much energy as 5 years ago. T is 7.
Frustrating.
Thanks....
Zytiga starting to fail, PSA rising rapidly - next steps?
PSA rising to 0.4 after 2.5 years Zytiga 
Rising PSA
PSA rising?
PSA Fluctuation and Zytiga
