Zoladex during Lutetium 177? Or not?

[Flydoggy]

Hello all, I am in a clinical trial and receiving 6 treatments of Lutetium 177 (1 every 6 weeks). I was diagnosed Gleason 9, 7 years ago and have had, RP, 33 sessions of salvadge radiation. Zoladex, Biclutimide, Daralutimide have all failed and I have developed metastatic cancer with numerous tiny bone mets and 4 spots on my liver. I also have a mass in my lower colon. I am taking my second treatment on Oct 12 and Doc wants me to maintain my 3 month injections of Zoladex. My question to the forum is whether or not this shot is necessary? I don't see much point as it has clearly failed and will not stop the damn march of this demon...if anything is going to do that it may be the lutetium treatments (fingers crossed).

Wondering if anyone has any info or experience with the dropping of the zoladex at this, or a similar point?

Also, 6 treatments of Lu177 seems excessive to me due to the potential damage to bone marrow etc. Does anyone know if this is standard of care anywhere else? I am in Vancouver, Canada.

Any and all advice is welcome and appreciated.

[tango65]

The cancer is metastatic CRPC and it should treated with ADT for life. The cancer is much more sensitive to the testosterone now than before, so Zoladex should continue.

Six treatments of Lu 177 PSMA may be necessary. The bone marrow is affected mainly in patients with multiple bone metastases and diffuse infiltration of the bone marrow.

[Concerned-wife in reply to tango65]

thank you..you taught me something important

[MateoBeach]

I would follow the trial protocol and advice. ADT accompanying and following radiation therapies has been shown to improve outcomes. Usually two years recommended. And Lu-PSMA is a form of radiation treatment. So that would be considered SOC.

I would inquire if abiraterone should be added to it. ADT plus abiraterone was recently shown to be better with salvage radiation following prostatectomy. So I am wondering if any implication for other forms of RT, including SBRT and also Lu-PSMA?

[RyderLake2]

Hello from a fellow Canuck,

I think you are looking at this the wrong way. As Tango, Mateo and others (presumably) will point out to you it is not that Zoladex, Xtandi and other ADT drugs have failed, it is just that they are not quite as strong as they once were. In other words, they have lost some of their efficacy. To come off them completely is to return to square one. Multiple drugs with different mechanisms of action are always better than one drug. Follow your oncologist's advice and stay on Zoladex.

[Tall_Allen]

Of course stay on Zoladex. You are castration resistant because your cancer has gotten much more sensitive to testosterone.

[cesces]

Seems like ADT is ineffective.

Maybe you should take a timeout and try bipolar androgen therapy.

[EdBacon in reply to cesces]

Bad advice. I agree with his doctor and what TA said. He should stay on ADT.

[cesces in reply to EdBacon]

Just to make clear, I don't view it as an either or situation.

Of course he should do what TA recommended.

I think he should use that 3 months to get some second opinions on following the current course of treatment with BAT in the event it generates disappointing results.

I should have been clearer.

[Ramp7]

I completed 6 infusions of LuPSMA177 under the Novartes trial study. All the time during the trial I received my 3 month Lupron injection.

[nobaday]

I just started the trial with my first Lu177 infusion in Vancouver on Wednesday. I had my Zoladex 3 month shot on Tuesday. I’m very excited to be on Lu177 . We should go for a drink sometime!

[PommyB]

I have been on Zoladex since 2013 with many 'holidays' of six or nine months as my reasoning is if it is only effective on average for 2 to 3 years, maybe the cancer gets around it by being under constant threat. As I still have a prostate, diminished by a TURP in 2013 and it was 70% cancer affected, Gleason 7 I stay on a diet (Budwig) that reduces the chance of metastases. My PSA has been as low as 0.9 and as high as 60 since then, but it was 75 in 2009 when I refused orthodox treatments, and was 138 before the TURP

I have tried several food treatments that have been backed by studies, Asparagus, White Button Mushrooms, Other Mushroom extracts, Chilli, they each have kept the PSA down for six months or so but it starts doubling every 6 weeks so I go back on the Zoladex.

At 90 yrs old I don't take things too seriously, I am remarkably fit for my age and don't take any other medications which includes any vaxxes. I have lost two family members and two art students from accelerated cancers after being in remission shortly after 'Boosters" .

Two of these died within a week of being re-diagnosed, draw your own conclusions. My best wishes and a prayer for your health, sometimes it 's better to live with your cancer under control than to try to eliminate it, the one that comes back is a doozy !