Next round of treatment underway

[shueswim]

Profile is up to date, but to summarize - 2nd recurrence with two mets discovered via PSMA scan (T3 and a rib). Treatment: 5 SBRT treatments to each met and 2 years of ADT plus Xtandi. All have started this week.

There was some discussion about adding Taxotere to the plan as well but the consensus was to save that bullet for later, though they said it was my choice. Any thoughts out there?

[Tall_Allen]

I'm not a fan of saving things for later.

[shueswim in reply to Tall_Allen]

Neither am I. Apparently, timing of triplet therapy is important. Given the fact that I’m one week into RT & ADT, what’s the window for adding the chemo component?

[Tall_Allen in reply to shueswim]

I think the important part is that the 2nd line hormone therapy and chemo starts at about the same time. The RT benefit is independent.

[Concerned-wife in reply to Tall_Allen]

Thanks for clarifying that. I remember you explaining that previously and it has helped us understand.

[Benkaymel]

It's a personal choice. Some studies have shown a relatively small improvement to OS with triplet therapy (ADT + AR + chemo) but you will be hammering your body hard with all that at once. My QOL at present is very good and I want to keep it that way as long as possible so I've taken the decision to go with the duplet of ADT (Prostap) + AR (Xtandi) at this time followed by radiation.

[Blueslover]

Nor am I a fan of leaving things until later if extra treatment could possibly help you in the long run. Tall Allen's recommendations are usually sound.Best of luck with the treatments Gene

Hugh

[Shooter1]

I hit it hard and early/ Became an invalid and recovered. Got to the 5 yr mark in April... Not bad for mCRPC and Gleason 9 to start with...... Best of luck with whatever choice you make.,

[groth12345]

I have 4 mets to the left shoulder blade and ribs. Been on ADT for 1 year with essentially zero PSA/Testosterone.

I've asked about RT (cyber knife) but the doctors have been resistant due to toxicity. Have you had this treatment before for your mets and does it work?

Also, have you considered Lu-177?

[shueswim in reply to groth12345]

Prior recurrence was in retroperitoneal lymph nodes. RT and ADT/abiraterone gave me 3 1/2 years of zero PSA. No issues from the RT, but ADT isn’t pleasant. Hoping this edition of whack a mole is as successful. With only two mets and me still being hormone sensitive, I don’t think Lu-177 is an option.

[groth12345 in reply to shueswim]

Glad ADT has been working well for you so far. Hope it works the same for me. Yes, it's not pleasant but much better to the alternative!