Triplet therapy after nadir?????

[Stoneartist]

Triplet therapy after nadir.

Just wondering. We have recently established that triplet therapy is a good thing to hit PCa with just after diagnosis when the tumours are active and visible on the scans.

I am about to get my next bloodwork and expect a PSA near nadir of 0.1. I have one (or more) castrate resistant tumours but everything is going well. I assume that there are millions of cancer cells now being held in check by Zoladex and Xtandi, but I don’t know if there is any non-PSA growth going on.

We have recently established that triplet therapy is a good thing to hit PCa with just after diagnosis. I am told chemo is the next step if something starts growing – should I be considering doing some form of chemo light regularly in addition to keep the present status – targeting new growth before we can see it in scans or symptoms – using a similar approach to the established triplet therapy.

Does anyone have any ideas about this – is there such a thing as chemo light??

[EdBacon]

Triplet therapy is something you generally do right at diagnosis or shortly after. Prior to that, SOC was either ADT plus Abi or ADT plus Docetaxel. Both of these were shown to improve overall survival so it's good that you did the early chemotherapy.

You've had a great response if your PSA is that low so I would think as long as it's that low and your scans don't show progression, you would want to stay the course. Lots of guys go years on Xtandi with low PSA (I went over 4 years on Abiraterone).

Once Xtandi becomes ineffective though, then it would be time to look at returning to either Docetaxel or second-line Cabazitaxel. Going to a different second-line anti-androgen at that point is unlikely to work.

These are things to talk to your doctor about.

[CAMPSOUPS]

Chemo only attacks rapidly dividing cells. With the markers of stability (low PSA, no progression on scans) the chemo will do more harm than good. No rapidly dividing cells to attack except hair, nails, etc.

[Tall_Allen]

PSA is your best indicator of new growth. Chemo doesn't work unless there are actively growing cancer cells.

[Stoneartist]

Thanks folks, I kindof expected that. So its Xtandi and ADT until something new is flagged by the PSA. It would be nice if they found something that would target newly forming tumours that we cant yet see.

[Niagarafalls]

My husband had been diagnosed with advanced prostate cancer last March and is now on Zoladex and Erleada. His PSA is now .01. His urologist says that Zoladex would only be effective for a few years but by combining it with Erleada he says that this treatment will be effective for many years to come.