I found out in October last year that I had several tumours in my spine, one in my rib and some in the lymph nodes that run up the middle/left side of my back.
As the bone and CT scans in March showed them getting larger and my PSA around 18.5, I went on ADT (Lucrin-depot). My medical oncologist is now suggesting adding either 6 cycles of chemotherapy (Doxetaxel) or Abiraterone. I have also been looking at adding either Enzalutamide (Xtandi), Darolutamide or even Apalutamide.
Can anyone suggest what may be the best one to add to my current ADT that may improve life expectancy without too many additional side effects.
Thank you in advance.
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x-rays1
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The best drugs to take for a man in your situation is a combination of Lucrin+ docetaxel+darolutamide (or abiraterone). This is called "triplet therapy." You can read about it here:
That was the plan for me, but (presumably) abiraterone caused my bilirubin to go up to 2.5 (had been 0.9) and told to stop for now. Just had my 1st Docetaxel chemo. Hoping to get back on abiraterone at lower dose.
Yeah, they talked about trying that after chemo is over, but wondering if worth trying during. Don't want to kill my liver while beating down my cancer.
If this is a de novo diagnosis or you already had primary therapy and these findings are a recurrence of the cancer?
If it is a de novo diagnosis triple therapy with ADT, docetaxel and abiraterone it is the best choice of treatment. If you have problems with abiraterone perhaps they could do the triple therapy using darolutamide if they could get it approved by insurance.
If this a recurrence of the cancer, the ADT plus docetaxel, or ADT plus enza or abi are therapies shown to prolong life.
Try to get a biopsy (liquid or direct) to do IHC studies, histological and genetic studies. The cancer may be susceptible to treatment with drugs such as Olaparib, rucaparib, Keytruda, Ipatasertib, or other experimental drugs in clinical trials.
Hi Tango65. Yes I guess I didn't give quite enough information in my post. It is not de novo. This is a recurrence. I had prostatectomy in 2012 and Salvage radiation plus 6 months ADT (Zoladex) in 2015. I thought that drugs such as Darolutamide and Apalutamide were only used when metastasis were not seen. I have had a genetic test which showed no muttions were shown. I haven't yet done IHC studies. Thank you for your response to my post. Really appreciated.
Would you please be kind enough to tell us your bio. Age? Location? When Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
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Darolutamide is only available for non-metastatic castration-resistant cases according to the drug description which would rule it out for x-rays1 (and me) wouldn't it?
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