My MO said that no need to have combination of ADT+ABIRATERONE+DOCETAXEL although early use it has benefits but we need to wait till PSA starts to increase. Currently ADT gives good result. But I know from past topics here that early use of that combo extends 2-2.5 years castraction period . I need your assistance and comments to discus with MO in the next appointment. My 2021 treatment results are listed in the below table.
thanks. Umit
After reading your introduction page and you latest post, my advice is to find a new doctor. Your PSA is very low, yet your doctor is burning through drugs and treatments like there is no tomorrow. A week on casodex, a month on Lupron. That's not even enough time to see if those drugs made any difference.
Dear Magnus, Casodex was used to reduce flame effect of first Lupron. 6 month later we saw Lupron failed (T was increased) than switched to Eligard which is similiar to Lupron Likely it worked
Your MO is right. You are recurrent, not newly diagnosed.
As long as your PSA doesn't start rising continuously there is no need to change your treatment.
The data of the triple therapy applies only to the few patients who have been diagnosed with de novo metastatic hormone sensitive PC. Your cancer is recurrent . Since you had a metastasis you could discuss adding one of the new anti androgens, but you have undetectable PSA since the direct treatment of the metastasis,
thanks, I had oligometastatic 1 point in jan2021, than SBRT applied. Lupron failed but Eligard have done good job.
Just continue you Lupron for BCR at this very low PSA time. Give it 4 or 5 years as is and just watch your PSA. Mine sat between 0.000 and 0.13 for 3 years before climbing. Then a little shot of radiation therapy to a couple of bones put it back to sleep. Life Is Good, don't over think everything...
Contact Dr. Kwon at Mayo in Rochester.
I too would advocate saving the options for later as your MO suggests. Keep the arrows in your quiver. Since you have had a bone met and are at risk for finding more down the road, consider going on a bone protective regimen now to be ahead of that, denosumab or zolendronate. Celecoxib added to these may provide additional survival benefit with little to no downside.
thanks, I will ask MO to add bone protective (currently I have manageable pain in the chest bone around the heart)
Merhaba! I believe reading your profile that you are oligometastatic (< 5 mets) and still have a chance for a cure. You responded well to salvage radiation/Lupron and the recent PSMA scan indicates the one met was successfully treated with SBRT. I would suggest continue 18-36 months of ADT, and continue to track uPSA and testosterone and take a PSMA-scan annually. Other markers you may consider tracking are PAP (pre-cursor to PSA, indicator of metastatic disease), and C-RP (inflammation). I was in a similar situation, stage t3bN1M0 and PSA dropped to <0.02 after radiation/Lupron-- MO suggested early chemo, but I declined because PSA was negligible, and did not want to add the toxicity of chemo for an uncertain benefit at a negligible PSA level. Now one year after stopping ADT, PSA is 0.04 and T is 700, without having done chemo.
thanks a lot having word hope to cure , (English meaning of my name is Hope)😀
Hello Afendi,
Tell your doctor what my Greek father used to say in Turkish when he would get angry or when he accidentally banged his finger (my English version) "Sickteerel"... I am just a poor Hamal.....
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 12/08/2021 6:52 PM EST
dear Nal, I just try to find way to increase castrate resistance period. Of course nobody can not estimate the exact resistance timing. Perhaps ADT will work 5-7 years more :). I had 1 bone metastases treated with SBRT, but in a day other will come.
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