Low PSA increased Mets

[BigTex3]

Looking for some advice. Diagnosed 7 July stage 4 Gleason 9 with Several bone Mets and soft tissue areas at 51. 4 months Zytiga, Prednisone and Zolodez. PET scan showed increase in Mets but no soft tissue. Switched to Xtandi with Prednisone and Zolodex. PSA at .35 just had PET scan and significant increase of bone Mets. Oncologist recommend adding Xofigo-Radium 223. Also going to MD Anderson in Houston. Interested in the groups thoughts? Continuing to be positive and praying for each of you daily.

[Hidden]

Some guys on this site have a similar reaction..low psa and progression

Is there a reason you haven't had chemo yet?

[BigTex3 in reply to Hidden]

My oncologist said zytiga/zolodez was the correct treatment. I had a second opinion from Dr Petrylak from Yale who agreed ADT was appropriate treatment. My PSA before treatment was 30. It just seems the bone Mets are extremely aggressive.

[Tall_Allen]

I think it's a good idea to alternate chemo and hormonals, perhaps adding carboplatin. Low PSA subtypes may not be very responsive to hormonal agents.

prostatecancer.news/2019/12...

ncbi.nlm.nih.gov/pmc/articl...

Perhaps discuss Xofigo combined with chemo as in this trial:

ejcancer.com/article/S0959-...

You might discuss a biopsy of a bone met with histology, IHC and genomics - there may be some other approved medicine or clinical trial you qualify for.

[BigTex3 in reply to Tall_Allen]

Thank you Tall_Allen. I really appreciate the information.

[GP24]

"Xtandi with Prednisone" - there is no need to add Prednisone to Xtandi. You can omit that. Provided this is not used against pain from bone mets.

[MateoBeach]

Xofigo may be beneficial at this point. Ask about getting Provenge along with it. More data supporting this combination just came out. practiceupdate.com/journals...

[BigTex3 in reply to MateoBeach]

Thank you Mateo. I’m open to anything to slow down or kill these bone metastasis.

[Irun]

I agree with GP24, no need for prednisalone with xtandi as it is usually only given with abiraterone (Zytiga). Both Xtandi and Zytiga do the same thing in different ways but only Zytiga needs the prednisalone unless there is another reason .

[CSHobie]

Hi Tex, I was diagnosed last year at the same age as you, and I am also fighting bone mets. Bone mets seem to be in a different category of: difficult to respond.

Ra223 is such a scary thing, reading the possible side effects.

I wish you best of luck and good science, we need more than luck.