On Lupron/Zytiga/Prednisone for nearly 1 YR - Stage 4 w/Bone Met

[groth12345]

I was diagnosed with Stage 4 (Gleason 8-9) last August and was immediately put on Lupron, then Zytig/Pred after 3 months. PSA was only 1.2 but actually more like 2.4 since I was on Finestride. Testosterone was 650. Now after 1 year, I'm at 0.02 PSA and <5 Testosterone, both immeasurable.

Prior PET scans revealed that I have 4 rib/shoulder bone lesions which are quite small in volume. The prostate was recently treated with 25 days of EBR.

I have a PSMA PET scan coming up next week. The previous scan looked like things improved by shrinking the cancer in all locations and in fact one spot was completely eliminated.

Just wondering if anyone on the same drugs have found that ADT alone can help eradicate and possibly cure the cancer if in small volume in bones/lymph nodes, etc? Also, if folks have used the recently FDA approved PSMA PET scan for analysis.

Thank you.

[GoBucks]

Yes, the combo of Lupron plus Zytiga became standard of care back in 2017 and are doing the job you wanted. I started that combo in late 2017 and have had undetectable PSA since then. Unlike you, I had surgery. Wishing you continued good luck. By the way, where were you treated?

[groth12345 in reply to GoBucks]

Thanks for your input. I was treated at URMC/Highland Hospital in Rochester, NY. I've had consultations with MSK as well which helped guide the treatment regimen.

[mrscruffy]

My treatment is the same, I have been in treatment for 6 years successfully. Don't think i will ever be cured just held at bay

[groth12345 in reply to mrscruffy]

It sounds like it's working very well for you. Glad to hear it!

Have you or your Doctors suggested Lu-177 to hopefully eradicate the remaining cancer cells? It's too bad one has to go through the first line of treatments to get to what I believe is this silver bullet. I could go to Germany or India for these treatments but insurance won't cover it.

[tango65]

The cancer is impossible to cure when it is metastatic, ADT plus zytiga is an effective treatment, it has similar results than ADT plus chemo. When it stops working there are other therapies available which can prolong life.

[groth12345 in reply to tango65]

Thank you.

I've been thinking of Lu-177 to get rid of the mets. Possibly going to Germany for treatment if there is a slightest increase in PSA or Testosterone. In the US, for FDA and insurance approval, one would have to wait until the ADT no longer works and then Chemo before the Lu-177. Howver, I've heard that if you have chemo prior, it may not be as effective.

[Tall_Allen]

Sadly, it never cures after there have been bone metastases. But it can help manage the disease for a very long time. Just because you can't see a met on a scan doesn't mean there are none.

[groth12345 in reply to Tall_Allen]

I've heard that Lu-177 can eradicate mets.

[Spyder54]

Im similar to you, but was Dx in Oct 2020 (22 mos ago).Zytiga-pred+Lupron(3 mos inject), finasteride, tamsulosin. I had 5 days of SBRT/SABR to primary Prostate gland and 3 days SABR to T5. Make no mistake, the Rad Therapy enhances the ADT battle. I went from PSA .95 down to .03 in 4 mos after SABR. Dr McBride says confirmation it is working. I hv not had any taxane (Docetaxel) which is SOC now. The next big fronteir appeats to be Immunotherapy. Waking up your White Blood Cells (WBC’s), and T cells to wake up and finally recognize the enemy (PCa cells) in their midst and begin methodically, slowly destroying them 24/7 (like a Ruumba vaccums one room at a time over hours). Hopefully to the point of submission (complete remission), but that may be 3 years way, or 10 yrs away. We just have to live long enough. C my Bio by tapping my picture icon. My best to you and yours, Mike St Pete, FL

[groth12345 in reply to Spyder54]

Thanks for your reply. Glad to head that your treatment is working.

I like the idea of having your own immune system fight the cancer. I would hope that immunotherapy is a possible treatment in the near future. Have you considered Lu-177? Unfortunately, one has to wait until the ADT and then Chemo stops working before the Lu-177 treatment. I've heard of stories where the cancer mets have been eliminated by this technique.

Good luck to you.

[groth12345 in reply to groth12345]

I looked up Provenge. I wonder why my Doctors have not suggested this approach. Anyone else on Provenge?

[Spyder54]

Several have had the Provenge treatment. Kind of strange, there is often no PSA drop, yet Overall Survivorship (OS) is clearly lengthened. You dont hear much about negative side effects. Also you asked about LU-177. About 1/3 get good results, 1/3 neutral, and 1/3 terrible. It seems like so many treatments….early is better. Also look at Mateo Beach Lutetium J-591 in Perth AUS. It appears the Ligand is more effective than 177 w fewer treatments.

One thing is certain, when Castration Resistance (Hormone Resistance) sets in, thing get serious real fast. Chessboard moves are critical. It seems like a giant human experiment constantly under change. I just read Tall Allens very thorough Research on BAT, mBAT, Intermittent ADT. Constantly evolving, but for roughly 60% may help restore Castration/Hormone Sensitivity, or prolong that stage for 1-5 years. We all present differently and we all react to different therapies differently. Mike

[groth12345 in reply to Spyder54]

Thanks for your insight.

I read your Bio and am very impressed with the research you have put into this. I've done some research myself but follow what MSK and my DRs at URMC recommend. They are still good with the ADT approach (only) as first line of treatment. My PSA has never been high (1.3 max) and with ADT it's essentially unmeasurable. Same goes for Testosterone. One of the lesions has disappeared, which is encouraging. However, how long ADT will be effective is unknown and I don't want further mets or cancer spread. So, like you, I am looking at what can be done before things get out of hand.

I've inquired about cyber-knife and Lu-177 but they don't seem to want to do further radiation (very small spot sizes that cannot easily be biopsied), and Lu-177 which is not FDA approved for first line therapy after or with ADT, only after other lines of therapy fail.

I will inquire about Provenge. I wonder if my insurance and my doctors will approve of this along with ADT. Have you tried it?

[Jackson1962]

I have been on lupron zytiga prednisone since last December. My psa when first diagnosed was over 8000. Gleason 8 stage four prostate cancer

Mets to hip and back. When admitted i was also in stage 4 renal kidney failure from enlarged prostate. Now my psa is down to .79. Mets have shrunk about .5-1cm. Problem is i know have kidney cancer. Mass is 5.7. Not sure what theyre gonna do with it yet. Fingers crossed