Castrate resistant prostate cancer

[Nicholas27]

Hello there back again. Unfortunately some more bad news received today. Grandads prostate cancer has now spread to the rectum, bladder and I believe on one of his vertebrae. Bicaglutamide no longer seems to be working. He is booked in for radiation tomorrow. Currently taking Lupron 3 monthly. What are the options now? I know the prognosis is worse now but I’m still trying to remain hopeful. Any advice will be greatly appreciated. I hope we can get the cancer halted and get back on track. Much love !!

[Tall_Allen]

He is also taking leuprolide shots, right? And he's had docetaxel. and whole pelvic radiation So it's time for abiraterone or enzalutamide. What country is he in?

[Nicholas27 in reply to Tall_Allen]

Yes that’s correct. We are in Australia

[Tall_Allen in reply to Nicholas27]

He can get Lu177PSMA617 in OZ.

[Nicholas27 in reply to Tall_Allen]

Would you recommend trialing enzalutamide before Lu177PSMA617 ?

Appreciate all your knowledge

[Tall_Allen in reply to Nicholas27]

He can do possibly do both together:

clinicaltrials.gov/ct2/show...

If he is randomized to enzalutamide only, he can follow it with Lu177PSMA617

[Nicholas27 in reply to Tall_Allen]

TA what are you thoughts on trialling a second line chemotherapy like carbazitaxel before going to abiraterone or enzulatamide ?

[Tall_Allen in reply to Nicholas27]

I think alternating chemo and hormonal works best.

[hansjd in reply to Nicholas27]

Lu 177 works even better when on Enzalutamide. Also at Genesis Care you can get Lu 177 together with Veyonda. Better still. You can Google it. Where are you in OZ?

[Nicholas27 in reply to hansjd]

Thank you for the information. I will look into this. Located in Qld Gold Coast !!

[ManavSadhwani]

You may Please consult Dr. Ishita B Sen (MBBS, DRM, DNB (Nuclear Medicine)) with detailed reports of your Grand Father. She is currently the Director and Head of the Department of Nuclear Medicine & Molecular Imaging at FMRI Gurgaon. Her email ID is [e-mail]

[meowlicious99 in reply to ManavSadhwani]

thats an oddly specific recommendation

Do you work for the clinic ?

[ManavSadhwani in reply to meowlicious99]

Yes

[meowlicious99 in reply to ManavSadhwani]

support.healthunlocked.com/...

prbly against site TOS. Check no 5.

[CAMPSOUPS in reply to meowlicious99]

I was hoping someone else would chime in but anyway Dr Ishita Sen is well respected by many members here and recommended from time to time by members when another member is looking for treatment.She and her staff work at a serious well respected medical institution not a "vitamin shop". Their institution is famous for treating with LU-177 in India when it is not yet available under insurance only in trials here in the U.S. although that is quickly changing.

Also it is common for a member to ask for names of Dr.'s in a state or country they have moved to so I think Dr. Ishita Sen's staff reaching out to try to help is not out of bounds.

[meowlicious99 in reply to CAMPSOUPS]

ok. you might be right.

[Thompsonk]

You have gone and are much more complicated area than I. Everyone is different, some get lucky, get it early enough, and get lucky with initial treatments. Only thing I might say, is stay as positive as possible, and just hope you have the correct doctors. Some are better than others.

God Bless, that can't hurt either.

[j-o-h-n]

G'day Nicholas, I hope your grandad tries what TA suggested, cause TA knows his gunna...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/28/2021 6:36 PM DST

[meowlicious99]

My impression of bicalutamide was that it used these days to control initial spike of LHRH.

Any specific reason he is on that long term ?

Did you MO suggest any 2 nd gen now that he is castrate resistant.

[Nicholas27 in reply to meowlicious99]

He must of assumed that dual therapy of bicalutamide and lupron will have greater efficacy. He now has ceased it though, said sometimes 1 in 6 people will have a drop on PSA after stopping it. He has suggested abiraterone. Also mentioned enzulatamide but said it’s better to trial abiraterone first rather than going the other way. I just really hope he responds well to these next line therapies. The radiologist said it’s spread out a bit in the pelvic region, and he won’t be able to zap the vertebrae, or rib regions. I thought it might be beneficial to radiate plus the oral therapy but he said that might be to aggressive.