Treatment Options

Was anyone here stage 4 metastatic to bone and lungs at time of diagnosis, and what were the treatment options offered to you?

[tango65]

I believe the best treatment options for your situation are the triple plans with ADT plus abiraterone and chemo or ADT plus darolutamide and chemo.

thelancet.com/journals/lanc...

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[EdBacon]

Triple therapies are currently giving the best overall survival. That's ADT plus chemotherapy plus an anti-androgen. See the PEACE 1 clinical trial results (ADT plus Docetaxel plus Abiraterone) The more of the little buggers you kill early on, the better off you are later.

[Brianne07]

Hi Tony i have 4+4 bone mets and lungs Originally my PSA was 370! Started on hormone therapy then 6 rounds of chemo finished chemo 2 weeks PSA now 0.19 so responded very well to treatment .See professor tomorrow to see what treatment i should have going forward .Most probably Zytiga .I live here in in Australia even subsided here it wiill cost me around $2000 a month.Will be asking about Generic Abira from India the same as Ztiga bit around $250 a month.I am a first aid trainer and work 3/4 days a week .Usually pretty tired at the end of the day and lethargic.Turned 73 today have a good diet and no pre existing medical conditions .Keep in touch if you like Regards brian

[Brianne07 in reply to Brianne07]

Hormone therapy was Firmagon

[dhccpa]

Metastatic to bones only. ADT was the only option after a full evaluation. Radiation was briefly considered, but rejected after PET scans. I was put on bicalutamide to lead into Lupron, bicalutamide then discontinued. You will probably be put on two ADT meds, as that's now the standard of care if you have more than a few metastases.

[Texan423 in reply to dhccpa]

Yes, PSA 3500, wide spread metastasis to bone. Treatment -orchiectomy, spot radiation, Abiraterone Acetate 1000mg daily (4 pills) and prednisone 5mg twice daily and for six months Xgeva (sic).Minimal side effects and PSA is consistently at .1 . Now 2 1/2 years since diagnosis and doing well. Not typical, oncologist calls me a “poster boy for prostate cancer”. I believe him after reading posts here and I am very grateful. Each of us is different and treatments that work vary for each of us. Good luck and fight hard to live well.

[Flyfisherbug]

Hi Tommy, Believe we are one of the rare ones to have prostate cancer in the lungs. I was diagnosed December 2019, Gleason 8 ,with Mets in pelvic bone and lungs. Duke offered 6 weeks chemo( Docetaxel, I think)and then Eligard and Xtandi. I went with UNC Lineberger who said I didn’t need the chemo up front and oferred quarterly shots of Lupron plus 1000mg Zytiga and .5 mg prednisone which I am still on. After 1 year started getting dizzy spells and prednisone increased to 10 mg which is current dose. Highest PSA 83, went down over time to .35 avg until early 2021 when it started up so had 5 days SBRT to 3 spots on pelvis. Currently .4. At 82, still enjoying life fully and traveling a lot. I try to swim a mile each day and/or walk 3-5 miles. Workout with weights 2-3 times per week. My main problems are no libido, hot flashes, fatigue, and transfer of muscle to belly. Wishing you successful treatment. Clay

[Hidden in reply to Flyfisherbug]

My diagnosis was May 2019, psa 629 and Gleason 4+5=9. Started immediately on Bicalutimide to Eligard every 4 mo. (changed to every 3 now) + Zytiga 1,000 mg+ Prednisone 5mg first year up to 10mg after that. Also added Xgeva every 30 days. After 2 years reduced to 3 mo. intervals in May 2022 Doc says I'm responding well. The weight gain and loss of muscle mass was not discussed thoroughly before starting treatment, and I've gained 50 pounds. Side effects are fatigue, hot flashes, bone and muscle pain, as well as the constant flu-like symptoms. I try to walk 30 min a day, but sometimes the bones ache too much, I do work in the garden and do some light hard-scaping , which gives a nice weight bearing workout. I'm curious how long the hormone therapy will work, and what symptoms might I have prior to psa rising, that it's no longer working. I don't think I was a good candidate for Chemo or radiation. Anyway, thanks for the info

[Izzygirl1]

My husband was diagnosed in June with that…. Bones, lymph nodes, ribs, spine, pelvis, legs, skull, lungs. Had 3 Firmagon shots. Starting darolutamide tomorrow and switching to 6 month Lupron shot next Friday. He hasn’t started docetaxel chemo yet because of anemia and will need blood transfusions…. But they are planning that for September. Triple Therapy. He’s feeling well right now other than feeling itchy!! We did go to Sloan in NYC and to Yale in CT for 2nd opinions and they said treatment plan is good.