I am 75 years old and have had Prostate Cancer for 16 years. The first 13 years was all Active Surveillance. Gleason Score of 3+3, PSA never above 12. Cancer was confined to the prostate. This all changed 3 years ago when my PSA rose to 12. I had a bone scan and a PSMA test showing the cancer was outside the prostate but confined only to the area around the prostate. I had Brachytherapy followed by 25 session of Proton Beam Therapy of the Pelvic area. I thought I was cured. Earlier this year my PSA started rising to 3.9. Gleason Score now at 4+3. Another bone scan and it was determined that I have Stage IV metastatic large volume cancer confined only to my bones. My doctor put me on Lupron and Darolutimide (Nubeqa). My PSA has dropped to <.01. I feel great and I am in excellent shape for 75 years old. However, my Urologist Oncologist says the Darolutamide (Nubeqa) will stop working in 12-36 months. He offers no hope for me after that! I am wondering if any of you could give me some advice on future treatments. It sounds like if some drugs stops working there are others to try. I am contemplating Docetaxel (chemo) and wondering the advantages of that. Any advice would be greatly appreciated.
Newly diagnosed Stage IV Metastatic P... - Advanced Prostate...
Newly diagnosed Stage IV Metastatic Prostate Cancer
Docetaxel is only a benefit if your PSA is rapidly increasing. After that Xofigo or Pluvicto and Provenge. Likely there will be more therapies by then.
Thank you, I will hold off on the Docetaxel unless PSA starts rapidly increasing. So I think you are saying that when the Darolutamide (Nubeqa) stops working there is Xofigo, Pluvicto and Provenge to consider to buy myself some time.
So far. Stay tuned. There will be more.
Tall_Allen is there research or reference re Provenge you can point me to? We have been told my husband’s cancer doesn’t behave like traditional prostate cancer, he doesn’t qualify for Pluvicto (not enough avidity) and were also told that immunotherapy hasn’t been shown to be successful for prostate cancer (yet I know is it in the NCCN standards for advanced prostate cancer).
Provenge is the only immunotherapy that has been proven effective for prostate cancer. It is FDA-approved for that since 2010:
fda.gov/vaccines-blood-biol...
I think the best way to use it is in combination with radiopharmaceuticals or chemotherapy. In your husband's case, combining it with Xofigo would seem to be ideal, as in the following clinical trial:
sorry to hear we have another warrior, my only advise is to find a oncologist that specializes in prostate cancer. There are lots of choices in treatments
Nubeqa study states psa progression free median is 33.2 months and metastasis-free survival median 40.4 months. I have been on Nubeqa since May 2021 with monthly Lupron, (Eligard failed). My psa reached <0.02 and <.5 T.
Those median numbers are not endpoints just next step points. New treatments come quickly.
I my case the suggestion is RP when psa progresses. I was diagnosed in 2015, G9, aggressive, oligometastatic.
Thank you so much. I really appreciate your response. It gives me what I need and that is hope.
Glad to help. Keep in touch via DM. We can help each other. Stay Positive.
Thanks again. I am embarrassed to ask but what is DM? As in "keep in touch via DM". I am still learning the abbreviations.
DM is direct message - text etc. As to all the other abbreviations, on the right side of the forum screen are pinned posts. One of them lists the abbreviations. All the best.
You have received good advice already. You might wish to read my book "An ABC of Prostate Cancer Today - 3rd Edition". It discusses many of these approaches. Get a hard or eBook copy from Amazon.
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