Radiation again or Chemo

[Ausi]

In the last 4 years, since failing Enzalutamide I’ve been successfully zapping Mets. In all cases, after radiation my PSA drops from about 20 to 3 slowly over a six month period. PET scans show only 2 Mets at a time. I’ve now had 6 treatments over the past 4 years, EBRT 60gy 30 days. Except for a lymph node all Mets have been on my right pelvis. It’s taken it’s toll, I’m limping and can walk for only 20 mins. My MO (like TA) reckons radiation is for pain relief. My RO reckons, in my case, the treatment works.

After my last zapping in Aug my PSA got down to 6.8 three months ago, but has now jumped to 15. If the Mets are anywhere near any previous zapping I can’t have radiation, in fact, if it’s the right pelvis I won’t. I’m 70 should I be opting for Chemo, “sooner rather than later”. Or, if it’s one or two mets and not on my right Pelvis zap em again. Any advice.

[Tall_Allen]

There is no proof that playing whack-a-mole accomplishes anything. If you continue with systemic therapy and the zapping is in safe places, why not? You are making the common mistake of thinking your PSA is your cancer. It is not. It is just a protein that larger tumors emit- so when you zap the ones you can see, that leaves probably thousands of micromets that you can't see. You have let those micromets establish themselves and grow just because your PSA was low. Systemic therapy is what you need.

prostatecancer.news/2020/07...

[Ausi in reply to Tall_Allen]

Thanks TA

[Grumpyswife]

We put off chemo for too long and regret not getting it sooner. Most of Grumpy's doctor's were against chemo but now he may need it to qualify for Lutetium.

[Ausi in reply to Grumpyswife]

Yes, my MO mentioned a trial with Radium 223 required candidates to have had chemo. I think I’m also just wanting to put off Chemo.

[Grumpyswife]

Be careful as we were told that Radium 223 may disqualify you from other trials.

I am impressed by most people's results from Taxotere. There is such a variation of results and tolerance though! If you research here and on youtube you will learn what to ask for from your MO--to give it a try and see how you tolerate it. Perhaps a reduced dose but I did not read your background for comorbitites. Icing of hands and feet has helped most people avoid neuropathy. And, chemo may reset the cancer so that you can get more time from abiraterone or enzalutamide.

[Ausi in reply to Grumpyswife]

Thanks

[Seasid in reply to Grumpyswife]

Exactly. I woul do chemo maybe only 4 to 6 cycles if there are side effects and try again with enzalutemide, maybe it works. Radiation only if absolutely nessesery to manage pain.

[Ausi in reply to Seasid]

Yep, I’ve been putting it off