An Enigma

[whwalker1]

I have written a number of posts earlier detailing my 22 year journey since RP in 1999.

The issue that I face is a high PSA(146) after Lupron, Casodex, Zytiga and Chemo ( Taxotere). I still receive an injection of Trelstar every 3 months and am currently taking the chemo drug Lynparza.

Thankfully I have no bone pain and PSA scan shows no change in 1 year for minor lesions in liver and spine.

My testosterone is less than 5 so I assume that it is not feeding cancer significantly.

My oncologist will be prescribing Xtandi next. What does this drug do?

I am trying to get into the Lu-177 trial because it seems to be effective.

Any thoughts?

[tango65]

I'll do the same try to get into a clinical trial with Lu 177 PSMA, or the trials with Ac 225 PSMA:

clinicaltrials.gov/ct2/resu...

[Hidden]

99? Holey Toledo walker! You’ve seen so much. At points in this struggle I guess it’s kind of like throwing spaghetti against the wall . To see what sticks. 22 yrs of fun is some kind of brutal miracle. As all #4 guys know. Advanced is its own animal . It Always comes back for more . We are all treading water . Some just don’t know it yet? Hang in there 🙏

[msnik in reply to Hidden]

" some kind of brutal miracle. "

what an excellent turn of phrase.....

[Tall_Allen]

Be sure to get both scans: PSMA and FDG.

[whwalker1 in reply to Tall_Allen]

What is FDG?

[Tall_Allen in reply to whwalker1]

FDG (fluoro-deoxy-glucose) is a different radioindicator for a PET scan that is used for almost all kinds of cancers. It is sometimes called a "glucose" PET scan - it shows cancer that metabolizes glucose. In later stages, prostate cancer metabolizes glucose and expresses less PSMA.

[Gabby643 in reply to Tall_Allen]

Thanks again TA

[myamic]

I take xtandi in the evening because it does seem to make me drowsy....try to take it at the same time 8p.m. ... I try to make sure and get physical exercise during the day. It is really easy for me to get lazy but I always feel more clear and alert after physical exercise. I feel the exercise is the best to help mediate the side affects of the lupron/xtandi combo. Sleep is very important but I short change myself often, but feel better with a good night sleep (not necessearily by hrs but get some good REM sleep. A Pwoer nap is also good...Happy Holidays, please take care!

[Boywonder56]

Have you inquired about erleada?

[whwalker1 in reply to Boywonder56]

I believe I have taken a similar drug. What is erleada prescribed for? Is it similar to Xtandi?

[Boywonder56]

Im on it with lupron for stage 4. Pc....have been < .2 for 4.5 yrs psa started to move up...last 6 mos.... i am in Titan trial.....you can google it..

[Hidden in reply to Boywonder56]

Good luck ! Go titan! 👏🏼👏🏼👍

[ishitasen]

Xtandi / Enzalutamide is an antiandrogen, oral capsule useful in the treatment of CRPC and mHSPC patients. However, the drug is a/w few side-effects which might be worrisome for some patients. Yes, Lu-177 is an effective treatment option which increases the progression free survival and improve the overall quality of life when added with standard of care as shown in the VISION trial in patient with castration resistant metastatic prostate cancer.