Next step. Comments?

[RunThru]

I posted a couple of weeks ago. Please look at that plus bio for more background.

After Taxotere (6 ending in Feb 2021), PSA went form 1100 (Aug 2020) to 8. From April 20 to July 10, my PSA has risen from 8 to 36. My Alk Phos has risen from 60 to 154. I have had some pain in my hips, sometimes bad, but not always. My doctor had me get a bone scan, CT and MRI over last two weeks. The MRI said: “many marrow replacing osseous lesions throughout the bony pelvis, visualized lower lumbar spine and the bilateral femurs to the level of the mid left and distal right femoral shaft, compatible with osseous metastatic disease.”

We have decided on Zytiga/Prednisone with possibly radiation as palliative care.

I can be more specific about anything.

Your comments are welcomed!

Also, my primary oncologist is compassionate but I want more opinions. I have touched base with Dr. Yin OSU but any suggestions for other good prostate cancer doctors in mid/west/south Ohio? My insurance is pretty limited to this area, I believe.

Thank you.

[Fightinghard]

No helpful suggestions, but will keep in my prayers for a good treatment.

[Tall_Allen]

Xofigo combos are worth a discussion:

prostatecancer.news/2021/02...

[RunThru in reply to Tall_Allen]

Thanks TA. You don't have to reply one way ot other. But I kind of want to get on a treatment. Ok, to go with zytiga, I think, and mine for combos

[Tall_Allen in reply to RunThru]

Xofigo is a treatment.

[tango65]

If you have testosterone levels below 50 and a progressive increase in the PSA, the cancer is castration resistant. You could discuss Provenge, a vaccine which could offer a survival advantage and Xofigo (Ra 223) which could be effective in treating the bone mets.

You could request a direct biopsy if possible or a liquid biopsy to study the genome of the cancer and to do immunohistochemical studies to determine if there are mutations or markers indicating that the cancer may respond to treatment with olaparib, rucaparib, keytruda or chemo with platinum based agents.

You could also consider a clinical trial with Lu 177 PSMA which could treat all the metastases (bone and soft tissue).

clinicaltrials.gov/ct2/resu...

I wish you the best of luck.!

[RunThru in reply to tango65]

Yea, seems to be the case. Thanks.

[tdouds]

I live in Lancaster and go to The James. I see Dr. J. Paul Monk III as my MO. I’m not familiar with Dr. Yin, but most all the Docs in GU Cancer there seem to have a clue; Dr Monk has kept me in the game for 14 years, and I’m still plugging along.

[RunThru in reply to tdouds]

Thanks!

[mikell in reply to tdouds]

14 years appears to be very admirable. I have great doubts my path will be anything like that.

[GeoffNoLongerAS]

One thought came to mind. Your last line says something about your insurance being area limited, you believe. I would contact the insurance company to understand what, given your situation, options if any are available.

Hope all goes well going forward.

[mikell]

What is your history before Taxotere? Do you still have your Prostate? Were you offered Cabazitaxel? Does anyone here believe Cabazitaxel can work when Docetaxel seems to be failing (PSA rising from 90 to 140 after first dropping from 600 to 90).