Is arbitrone failing

[Muffin2019]

Been on arbitrone for 1 year and 1 month increase in PSA from. 7 to 1.8, on eligard, since beginning, xgeva monthly until November of 2021 now every 3 months. Just had a CT and bone scans, the cat scan showed no disease progression and the bone scans no new Mets as the old one's have healed over 2 years ago. Due to the rise in PSA can something be added to keep the arbitrone working longer, do not want to burn through medicine so fast. What would be a reasonable next step the oncologist might suggest, feel great, still working 20 to 24 hours a week at 70 with no plans on stopping work for another 2 years or more. I still get the intense hot flashes every day and night. I am taking dex with the arbitrone.

[Tall_Allen]

I think alternating chemo and hormonals works best. Sometimes it works again after chemo.

[Muffin2019 in reply to Tall_Allen]

I did 6 rounds of chemo in 2018, would it require the same 6 rounds again ? If the cat and bone scans are good then why is the PSA going up although it is still low. I am seeing him on the 11th, just gathering information so I can ask intelligent questions as to the next step. I did very well with the chemo then and would it be the same stuff ?

[Tall_Allen in reply to Muffin2019]

You can probably wait until there is some evidence on a bone scan/ct. Jevtana may be a good choice:

prostatecancer.news/2019/12...

Or you can try a combo of Jevtana, Xofigo and Provenge, if you can get them (go back to monthly Xgeva if you have Xofigo):

prostatecancer.news/2021/02...

[Muffin2019 in reply to Tall_Allen]

Thank you, the doxental lasted successfully for 2 years before PSA increased, is that a possibility to use along with arbitrone ?

[Tall_Allen in reply to Muffin2019]

Yes, you can keep taking it if you want to, at least until there is an increase in metastases.

[Seasid]

Could you get a PSMA pet ct scan and see if he has a CRPC in his prostate? I had that situation and I did the SBRT radiation of my prostate. You could also ask for a mpMRI and calculate the PIRADS score and see how the PSMA SUV max correlate to the mpMRI findings.