Chemo after xtandi?

[mcom]

My father was diagnosed in 2015 with PC Gleason 9 but his margins are clear and no distant Mets. He had 2 “hot spots” but after the operation and Luperon injections every 3 months and Xtandi they disappeared and he has had an undetectable rating since then. Doctors are telling him that eventually this will fail and chemo is the next course of action. Has anyone had experience with this? It seems drastic to jump to chemo when he has no pain and no known tumors. I assumed there would be another type of immuno drug he would be moved to. Even though he is in the clear for now I just like to know what the next potential steps would be.

[Tall_Allen]

There is no known cure for metastatic prostate cancer. I'm glad his therapy is working., and I hope he will be able to live with his disease for a very long time. Think of those metastases as the tip of the iceberg - it is only the part that you can see. The disease is still in him - cancer cells are in his blood, lymph, bones, and nerves. They will eventually grow bigger. You may want to read this:

nccn.org/patients/guideline...

[mcom in reply to Tall_Allen]

Thank you!

[mcom]

Thank you for explaining that!

[catsup]

I went through the same process. Diagnosed 2014. Am currently on Xtandi , which I have been on for past 3 years. It is showing signs of not working anymore as my PSA levels have started to rise from .02 to .33. My Oncologist has advised me there is no other drug to replace Xtandi or to add to Xtandi. Her next step of treatment is not chemo but to identifythe active cancer cells that are causing PSA to rise and kill them with Radiation. That should bring PSA down. She has done this successfully for a number of her patients. Eventually I will need Chemo. I have read in other posts where Chemo is first line. So you should discuss with your Doc. Also hopefully before your Xtandi stops working some new drug or trial will come out . Stay positive and good luck

[mcom in reply to catsup]

Thank you! Just gotta keep pushing forward! There’s always something else to try! I feel better knowing about the options.