Failing Xtandi

[Hotcars74]

Have I failed Xtandi, if so, what are my best options, My PSA doubled in 6 months July 19 (1.31) Dec 13 (2.69) I get checked each month, I see my oncologist tomorrow afternoon, not sure what to discuss, wondering if the other shoe is starting to fall, need advice please, thank you so much

[Hidden]

You have quite a few options. No worries.

[Hotcars74 in reply to Hidden]

TY for the reassurance, take care

[Tall_Allen]

discuss docetaxel, Provenge, Xofigo, genomic and IHC analysis

[Hotcars74 in reply to Tall_Allen]

ty Tall Allen, dr wants me to do PSMA scan, to see where the progression is coming from

[Tall_Allen in reply to Hotcars74]

How will that change your treatment?

[Hotcars74 in reply to Tall_Allen]

doctor wants to see if the 2 spots on my spine L-2 & T-6 are at fault, if so he wants me to Radiate them, we have been down this road before and I passed, please give me your take, I think You feel the same way I do about radiation ? ty Allen

[Tall_Allen in reply to Hotcars74]

Well, it will probably reduce your PSA, but I don't know if it will do anything to reduce your cancer. Maybe. Maybe not. Given the lack of evidence, my feeling about it comes down to safety. If it's safe, why not?

But, if he is serious about finding more bone metastases, he should ask you to get a NaF(18) PET scan - it detects about twice as many as a PSMA PET scan. Inexplicably, Medicare no longer covers it. I don't think it is nearly as expensive as a PSMA PET scan, but it will be out-of-pocket.

[Hotcars74 in reply to Tall_Allen]

safety is alway a concern, the radiation onc, said there was a 15 % chance something could go wrong, dont remember what it was, not being able to eat or spine collapsing ? the out of pocket cost of the other scan would depend on what treatment for the extra findings , why are we looking for more mets if we already know their there I really appreciate your feed back TA

[Tall_Allen in reply to Hotcars74]

I agree with you. We will always have increasingly better technology to find smaller and smaller metastases. As you said, what is the point? Sometimes it is possible to radiate them so they don't get bigger and cause the bone to fracture or collapse.

[Spyder54]

I failed Xtandi right up front w T rising each month and PSA following close behind. Many said Zytiga probably will also fail. Not in my cade. T plummeted to zero and PSA WENT LOWER now 8 months in a row. Each man is different. Remember. Mike

[Hotcars74 in reply to Spyder54]

TY Mike, Im glade to hear that Zytiga is working well for you, I'll keep that as a option, my doctor has other plans for now

[Magnus1964]

You still have zytiga. It works differently then xtandi. I have been on both and both worked well. Although, everyone responds differently to medications.

[Hotcars74 in reply to Magnus1964]

TY Magnus I'll keep Zytiga as a option if needed, right now I got to go with the Doctor

[cesces]

Also investigate bipolar androgen therapy.

[Hotcars74 in reply to cesces]

TY cesces, take care

[2dee]

Have you been genetically tested for BRCA 1 or 2I've switched to Lynparza with great success for last couple months. I'm BRCA2 positive.

2Dee

[Hotcars74 in reply to 2dee]

TY 2Dee no i dont think i've been tested for BRCA, but will look in to it, Im glad to hear that Lynparza is working for you, and stays that way

[2dee in reply to Hotcars74]

Contact the genetic counselor for your provider to get started. A phone interview questioning your family bloodline cancer history. I inherited my gene mutation from grandfather, through mother. Only a small percentage fit but only way to qualify for treatment.

2Dee

[EdBar]

I’d recommend Provenge while PSA is <5, that’s when it’s been found to have the best survival benefit. Although typically it doesn’t lower or slow PSA increase in some instances it does. I have also begun to fail Xtandi or at lest there’s a tumor somewhere that has figured out a work around. I underwent Provenge treatment in August/September and since then my rate of PSA increase has slowed by about half. Future options for me include BAT and then rechallenge with Xtandi or SBRT, all of which depends on what PSMA scan shows. You might want to start with a PSMA scan to see exactly what you are dealing with and go from there.

Ed

[Hotcars74 in reply to EdBar]

TY Ed yes we are going to start with the PSMA scan, and go from there, good luck with your treatment