Advice on radiation treatment?

[DDCD]

Hi, my husband (57) and I are new here. My husband was diagnosed with Stage 4b many mets to lymph system in pelvis, abdomen and the subclavicular lymph nodes in March. He’s on Lupron, was on Zytiga until his liver enzymes went way up (ALT 559 and AST 230) and will get radiation soon. The RO said he can only do radiation on the main tumor in his prostate. Why wouldn’t they also try at the subclavicular lymph node site?

Since we only discovered this by an ER visit (CT scan saw enlarged pelvic lymph nodes) and subsequent PSA of 387, we are still in shock and really don’t know what to expect. We are told there is no cure but also we don’t even know how long we might hope for? 5 years, 7?

Thank you in advance from scared and worried new members

[EdBacon]

Based on my limited knowledge, Zytiga can raise liver enzymes so it would make sense to me to stop the Zytiga and see if they go down. ADT alone is usually an effective treatment for those newly diagnosed at stage 4.

Many patients add 6 rounds of Docetaxel chemotherapy at diagnosis and that is proven to extend life expectancy. The best option is ADT + chemo+ Zytiga, but if he can't do Zytiga, there is ADT plus chemo and I believe he could also add Xtandi. Best to talk to his doctor.

What is the current PSA?

[DDCD in reply to EdBacon]

Thank you, current PSA is 4.1

[DDCD in reply to DDCD]

correction, PSA is 1.3 currently

[EdBacon in reply to DDCD]

So sounds like his main treatment of ADT is working as it usually does at diagnosis. Definitely would stop the Zytiga and see if the liver enzymes go down. Once that's resolved, he could discuss adding other treatments to potentially add life expectancy if he wants to do that.

[DDCD in reply to EdBacon]

Thank you, take care.

[Hidden in reply to DDCD]

This is a great response ! Let it keep dropping to undetechable Psa< .1

[DDCD]

We certainly want to enjoy them. We just don’t know how to plan. He feels great now. I wish I could retire, but we need my income. We are planning to take as many vacations and fun adventures as we can.

[EdBacon in reply to DDCD]

My doctor just told that based on what he's seen, the median life expectancy for stage 4 prostate cancer is 5 years from diagnosis. Of course many go well over that and in the next 5 years there will probably be new treatments that take that even further. I'm over 6 years now and still going strong. There's hope!

[DDCD in reply to EdBacon]

Thank you, that’s good to hear!

[Hidden in reply to DDCD]

First knock the pc out of the park . Then vacation . ✌️❤️

[Fightinghard]

Each of us has an expiration date that is set by God, not doctors. Find a good MO, follow their treatment guidance, then focus on living your life not worrying constantly about things you can not change.

[DDCD in reply to Fightinghard]

Thank you 🙏

[Tall_Allen]

The purpose of the radiation is to slow down the progress of the cancer, not to get rid of all his metastases -- there are many more that are too small to show up in a scan. The subclavicular metastases are in a particularly dicey site to give radiation.

He can get docetaxel and darolutamide, if his liver can handle it:

prostatecancer.news/2021/05...

[DDCD in reply to Tall_Allen]

Thank you 🙏

[Hidden]

Welcome DDCD , you have come to the right place for info on pc . Each of us here with the same #4 knows how you feel and what you’re going through we’ve been there in those shoes . It can overload you quickly .. take deep breaths , take care of yourself also in all of this turmoil . The stress and fear of the unknown is real . We’ve all felt it . We are told that there is no known cure for #4 . That said , some have lived decades beyond even worse dxes . There is hope . You both can’t ever give up . It’s a battle for his life . I was 53 over 7 yrs ago when I did imrt & Lupron and Tak-700 (similar to zytiga) I also did alt med and followed a Nat docs nutrition and diet plan . I think that this has made the difference for me . I’m sorry he has this . Us with this can relate to you both . Ask questions? Everyone is scared and worried by this . How could we not be ? . He can push it away for years like I have . Keeping his spirits up is half of the battle . Some men fly by ( they say) relatively unscathed . I was hit hard for years with a bad urology tubes into the kidneys and a foley . The drugs and RT shrank my tumors away . It was two yrs of hell . We all suffer to different degrees . Love is the best medicine . He has you by his side . This is great ! Love each and jump through the hoops to a better place .. Stay strong and positive . Please don’t feed into negative stats or opinions .. Take care …🙏❤️ Scott

[Nusch in reply to Hidden]

What a great answer, good for all of us. Many thx and all the best for you, too!

[Hidden in reply to Nusch]

We all must roll with punches! Thank you ! 😔👍

[DDCD in reply to Hidden]

Thank you for such a thoughtful response. I will take it to heart. I know you are right.

Also, I’m so glad you and others have done so well! XoXo

[Hidden in reply to DDCD]

I’m not here to be right . We just don’t want him to suffer more than he has to . You two are not alone in this fight . We support you . 🙏❤️❤️

[Break60]

As of June 2024 it’s been 11 years since I was DX with Pca Gleason 4+5=9. My psa has never been higher than 13 so I am high risk low volume. If you look at my profile you’ll see I’ve had Mets primary in bones but they’ve been few (oligomets) and treatable with SBRT. So I’ve been “lucky”. All of us are different , so predicting how long we’ll live is not a productive use of our time. Just live your best life every day.