Is this what you’d expect

[Farn]

My first PSA reading is 0.2 after Zoladex 3 month after 1st PSA 102 in December 2021 1 bone met in Sacrum

Is this a reasonable first outcome of what’s going to be an ever changing rollercoaster ?

Thanks

[Tall_Allen]

Fantastic response! But you're getting more than just Zoladex, aren't you?

[Farn in reply to Tall_Allen]

I’m getting the ADT fortified with Enzalutamide next week just needed to get my blood pressure down first due to possible hypertension SEThen they are looking to radiate my prostate and possibly the metastases as well after 2-3 months

dependant on the shrinkage of the tumour (hopefully)

I was originally going to go on docetaxal but I emailed Nick James at Royal Marsden London as he said in 2019 that as long as they took Docetaxal 80% of his low volume men were living 5 years+

I asked him if he still stood by that statement and he suggested that their men go. down the route I’ve now elected to go with the Enzalutamide + Radiotherapy in the scenario I’m in.

The NHS won’t fund Docetaxal at the same time so the triplet is not on the table.

Thank you for taking the trouble to respond

[Tall_Allen in reply to Farn]

Too bad they're not offering triplets yet. Lacking triplet therapy, I think logistically, it makes sense to do docetaxel first. The reason is that 6 infusions are completed in just 15 weeks, and enzalutamide can begin as soon as PSA rises; whereas if you begin with enzalutamide first, it will probably take about 3 years until resistance kicks in and docetaxel can begin. So you would probably get both sooner if you begin with docetaxel.

Either way, prostate radiation makes sense.

[Farn in reply to Tall_Allen]

Thank you again your logic makes sense I’ve set my stall out now I have the tablets I hope it doesn’t disadvantage me too much

[Farn in reply to Tall_Allen]

Looking at your horizontal graph from ESMO the Aberaterone gives a better outcome than docetaxal first should this not be taken into consideration ?

[Tall_Allen in reply to Farn]

No - it's a different group of patients. When patients were randomized, both had the same benefit:

ncbi.nlm.nih.gov/pmc/articl...

[CAMPSOUPS]

I looked at your previous posts and couldn't tell.Are you currently getting chemo infusions as well.

It looked like for you a good treatment scenario would follow the PEACE-1 protocol.

ADT(Zoladex or Lupron or Eligard, etc. ) chemo and abiraterone.

Whatever your treatment (looks like at the least you are getting Zoladex) your PSA response is excellent. You very well might go a long, long time without being on the roller coaster as you said. So far so good. You are responding. That alone is not guaranteed so congratulations.

[Farn in reply to CAMPSOUPS]

Thank you for the comments and informationThey won’t allow / fund the triplet

currently

[ishitasen]

Yes, you have responded quite well to the Zoladex 03 months, due to which your PSA levels have decreased drastically and this situation can remain so for a longer duration of time, depending upon the biology of your tumor. It would be advisable to keep a watch on your PSA levels 03 monthly. If there is a rise in PSA levels, disease recurrence might be suspected and you may require further treatment.