Next Steps after Docetaxl

[Vangogh1961]

I was diagnosed in December, Gleason 9, with one pelvic lymph enlargement, T7 and sacral met. Started on ADT and have completed 6 rounds of Docetaxel. My PSA has gone from 15.4 to .2. I have new scans this week for possible radiation oncology through MD Anderson in AZ. Reviewing the Peace trial, I don't necessarily see a benfit to the radiation and feel I should be advocating for Abiraterone instead. I'm open to thoughts/suggestions.

[Magnus1964]

You might start with casodex. You should have an ADT drug just before radiation anyway to try to contain the Pca in the prostate.

[Vangogh1961 in reply to Magnus1964]

My bad. I've been on Firmagon since February.

[Tall_Allen]

Be careful about using PSA as the way you "see a benefit." Debulking the prostate with radiation improves survival - it won't be apparent now, but it will slow the spread from prostate to metastases. I agree that abiraterone may be helpful too.

[Vangogh1961]

It makes sense. I just wasn't sure about the possible side effects vs added benefit, since radiation wasn't considered SOC under the trial.