Next steps? Zytiga and Radiation

[dch1953]

Hello,

Just saw dad's MO today. PSA is doubling every month and is currently at 0.22. Scans that include CT, bone and MRI came back unchanged from November 2021. Regardless MO believes the cancer is active again as dad's symptoms (frequent peeing, extreme fatigue) are getting worse. He has offered zytiga and radiation of the prostate. MO mentioned there is no guarantee Zytiga even works, and if it does work, he might get 4-5 months out of it. The radiation is for palliative purposes to hopefully help with the symptoms. Radiation to lungs/liver is not possible due to the number of mets there. He also said docetaxel is on the table as well. He started with this treatment in July 2021 and it was really effective as lung and liver mets greatly decreased but he had pretty bad side effects.

Based on what I've read, it seems to be the right steps. I'd love to hear your thoughts.

Also, anyone have information on when LU177 would be available in Canada? More specifically Ontario.

Thanks,

[Shooter1]

If he handled docetaxel without too many SE's. it may be worth a re-challenge with it and the addition of zytiga can really help. With my first BCA the ALP climbing was first sign. It climbed for 6 mo. before PSA went up and new bone mets were evident with Na-F18 scan. Here's hoping the zytiga and RT will hold his aPca back for an extended period.

[dch1953 in reply to Shooter1]

Just looked at his ALP, it is rising like his PSA but a much slower rate. I hope the Zytiga keeps the cancer inactive for a year+ like many here.

[john205 in reply to Shooter1]

Zytiga a good choice. Another option is enzalutamude (Xtandi). I began Xtandi when my PSA began rising 2 years after Docetaxel. I had good results for around 15 months. PSA may be rising slowly again but there are no other signs of progression. Another round of chemo is another possibility. Keep in mind that each case is different. Rely on your MO for advice and ask about all the options. The MO will have all the details of your father’s case.

[Tall_Allen]

Maybe he will tolerate Jevtana better.

[dch1953 in reply to Tall_Allen]

Will bring it up with the MO at the next visit

[Chrisbaird]

Been on Zytiga 500gms daily for a year has kept PSA low Started on 1000 gms for 3 months till liver toxicity developed slight fatigue only side effects Good luck !!

[j-o-h-n]

Will Keytruda work on his Lung mets?............... it worked on my lung melanoma.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/04/2022 7:15 PM DST

[Janhpr]

Hi we are from the UK gone privately for Lutetium 177 expensive £13000 at Genesis, in Windsor, 2nd treatment tomorrow, all bloods normal except slightly anaemic. PSA was 10.9 and after first Lu reduced to 9.4 ALP 69, are we missing something, you say your Dad PSA is 0.22 that appears low to us. I will keep you informed of my husbands progress of Lutetium 177, keeping our fingers crossed that it will be successful. After this 2nd treatment will have a PMSA PET Scan which should tell us if its attached to the widespread bone mets he has. We have been told no organs involved but they could be hidden.

[db1966]

I did 3.5 yrs on zytiga and tolerates it really well. When it stopped working we switched to xtandi which did not work at all came off it after 12 weeks.

[alsam]

Good Afternoon....just read your article...surprised about the doctor's statement....I am a ten year survivor of Advanced Metastatic Prostate Cancer Stage 4 with a presenting PSA of 509 ng/ml...After six months of treatment I saw my PSA reduce to less than 0.1 ng/ml where for over 9 years it as not risen significantly. My current reading measures 0.35...Yes there are some side effects however I have been able to manage them....Overall my condition remains well-managed. In talking with my consultant he remains amazed at such a statement...It does not work for everyone but most of us can attest to the extension of life it as given us and our lived ones...