Recurrent cancer; RP Jan 2019; removed 11 nodes; 3 contaminated. IMRT, Lupron for 18 months and Zytiga for 12. October 2021 Gallium PSMA scan showed one micro cancer in node behind breastbone. No ADT repetition. June PSA back 0.55.
Waiting on new treatment plan. Friend is on Xtandi alone and is in similar position but is undetectable. Thoughts? I HATE Lupron.
I would not start with Xtandi at a PSA value of 0.55 ng/ml. Just observe and get another PSMA PET/CT when the PSA value rises above 3.0 ng/ml or higher.
I am hormone sensitive PCa and have an extensive background. I started Xtandi almost six years ago as a mono treatment as my latest off treatment period came to an end. I have been on varying doses from 1/day to 4/day in the intervening time and the only noticeable side effect is breast growth which stopped after ~ six months of treatment. Some muscle weakness now but at age 74-75 could be anything and nothing specific. My oncologist at the initiation thought it the best choice and my current onco continued the treatment and calls me his "outlier". I started with a sub 1.0 psa but my history indicated the certain trajectory from undetectable. Current onco says that if psa rises during this monotherapy he prefers a radio-pharmaceutical first before a return to Zoladex or equivalent. I asked my current onco about a drug vacation and he declined. I want to be a compliant patient so I agreed.
Off topic view: Doctors receive the patient compliance they earn.
At what number did you start the mono therapy.
I have been on Xtandi as a mono-therapy for 8+ years with obviously great success. As you know everyone's journey is different. Originally diagnosed in November 2000!
What was your PSA when you started mono-therapy
It was 2.3
It is not a number issue. My off periods tended to be short, 8-24 months total including the period prior to testosterone recovery, which in my case was normally rapid and within a short time. Then my psa would increase at a doubling time of 30-45 days. This occurred over several off periods. That is what I referred to as my "trajectory" in my original post. It is more than a single number, it is a history, trend, pattern. I knew what the onco meant and thought there was no real benefit from waiting. What if I wait and the Xtandi does not work? This is about the long term not the immediate potential, which may not be realized. (speaking about my case)
Interesting, where do you go for this treatment? That sounds like a good way to extend castration sensitivity.
Everyone here means well. That said, your doctor knows you and your situation best. Get a second urologist or oncologist opinion if you would feel better. That's what we did just to get the most information. Nobody on here can or should tell you what treatment is right for you. We can sympathize, compare our journey and give support to you. Please, listen to your doctor first, as cancer cells and treatment react differently in everyone.
Thanks; we did that for a single node behind my breastbone w/o ADT in January. PSA dipped then June 22nd, it was back up to 0.55. RO said check in 60 days; I'm testing 30 past last test.
xtandi 
Xtandi
xtandi 
Xtandi side affects
Xtandi
