Switch of corticosteroids from predn... - Advanced Prostate...

Advanced Prostate Cancer

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Switch of corticosteroids from prednisone to dexamethasone

Tonyliv profile image
3 Replies

Diagnosed December 2017, see my profile.

Since radiotherapy December 2020, it has taken around fourteen months for my PSA to go from 0.07 to 1.2, with slow and steady progression of about 25% every four weeks. Obviously exponentially, I'd like to make sure it doesn't go from 7 to 1200 the next fourteen months!

The abiraterone is fighting a great rearguard action, but slowly failing. I’d like to keep it efficacious as long as possible.

I understand a switch of corticosteroids from prednisone to dexamethasone to halt or slow growth, which happens in a majority of cases, is particularly beneficial to those with lower PSA at the switch, and give longer mCRPC -free survival. See: pubmed.ncbi.nlm.nih.gov/300...

Has anyone had this experience with some success? Oncologist supportive? Based in UK.

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Tonyliv profile image
Tonyliv
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Kentucky1 profile image
Kentucky1

My MO approved the switch, although he seemed to have little faith in it working. My PSA has dropped from 74 to 66 after about 45 days on dexamethasone. I get blood work again this upcoming week and am hoping for a continued response. Like you, I am trying to "squeeze all the juice from the lemon" as possible from abiraterone. I've been on it for 3 years, initial PSA of 368, got it down as low as 2.5 after the first 2 years, year 3 has seen a slow steady increase,with big jumps this past few months. Best of luck to you, hope you get a good response.

SeosamhM profile image
SeosamhM

Indeed, I had success switching from P to D for about 18 months (PSA started rising in May, similar to your curve, so I'm now at 2 point something or other, I'd guess....).

Switching is an innocuous (in our world) change in treatment, so I don't understand oncologists' dim view. I had to insist with my first oncologist, since sacked. I was told that they didn't like the "side effects" of D...uh, how about the side effect of me definitely having incurable cancer in my early 50s and - like all of us in this group - trying to get the most from one treatment before moving on to the uncertainty of another? I need intelligence in my care team, not high-mindedness.

It's not like this switch from P to D is new ground:

sciencedirect.com/science/a...

And if someone wants newer results - even newer than your recent 2019 cite:

bmccancer.biomedcentral.com...

Good luck, Tonyliv! - Joe M.

Engraver68 profile image
Engraver68

I made the switch 2 months ago as PSA was rising. I also had some palliative radiotherapy to 2 areas of bone Mets in groin and spine.

PSA has dropped from 1.9 to .44 and remainef at this level fit 2 months.

Oncologist and O both delighted I stay with abitaterone for now review in 6 months.

I'm in Liverpool so standard care in UK

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