BACKGROUND: The management of metastatic castration-resistant prostate cancer involves second-generation antiandrogen therapy, including enzalutamide. The recommended dose of 160mg/day is sometimes difficult to use in elderly patients because of the burden of comorbidities. The usefulness of a low effective dose remains unclear.
METHODS: We report the first ever patient, now aged 87 years, who had progressing prostate cancer and was treated at 25% of the recommended dose for over 4 years.
RESULTS: The most striking observation is that nothing extraordinary happened. The disease responded without dramatic toxicities. His follow-up has been serene on both aspects of prostate cancer and general health.
CONCLUSION: Cautious dosage can have a long-lasting favorable impact in the elderly patient.
Congrats! I've been on low dose (50mg) bicalutamide since June, 2018, PSA <0.1 - tested every 3 months but last test was 6 months ago. Labcorp posting results this coming Tues. We shall see. 74 yrs old and holding!
i tried dutasteride instead of finasteride, since the dut. hits pca cells as well as healthy prost. cells. Found i couldn't control incontinence as well, so went back on finast. But i still have my gland, so we have different situations.
I’ve been using Xtandi for five and a half years and have been on a half dose for two and a half and it is still working. The 160 mg SOC was the maximum that could be tolerated when it was going through clinical trials.
Many seem to think getting to undetectable will somehow cure them... rather than lowering PSA to a stable low number and trying to control and slow the progression over a decade or two. That way the cancer doesn't become as aggressive. Driving the PSA to as low as possible with high doses rather than dropping it 80% or so with half or one quarter doses may make the medicine last 2 or 3 times as long. Also the damaging side effects to other parts of the body may be less.
When I was seeing Snuffy Myers his goal was always to drive cancer into dormancy, or long term managed remission. He felt that a smoldering, festering cancer allowed for nasty mutations to develop. Therefore he always tried to reach an undetectable level.
totally agree. i'm ok with the side effects of the combo i'm using, largely because i'm 74 yrs old, single and live alone. To younger men, losing erection is devastating and gynecomastia doesn't make for a pleasant sight in the mirror but i'm alive, can still achieve orgasm and who knows? Maybe a woman could work magic on me! As some of us know, the fair sex have mysterious powers.... 😅
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ASCO 2019 Abstracts.
