Should I be doing more.

[Letsfish]

Diagnosed 11-9-21. PSA 1998, ALK PHOS 750, Gleason 4+5. Lots of mets mostly bone. 11-17-21 started treatment. 3 month Lupron injection followed 2 days later with 4 month Zometa and 1st of 6 cycles of docetaxel. At 2nd chemo PSA 301, ALK P 1730. At completion of chemo 4-8-22 PSA 2.45, ALK P 280. Today I am still on the Lupron / Zometa treatment with PSA .32 (PSA has continued to drop some every blood test), ALK P 81. I do take low dose Morphine for the pain. After reading on the site it seems a more aggressive approach to drop my PSA would have been best. My pain is beginning to increase so it might be to late anyway. My question is, should I be doing more or is what I’m doing good until a scan or blood work shows something different. Thanks.

[rsgdmd]

What have your follow-up scans showed? Any new mets? Any shrinkage of existing ones? As per PEACE-1 trials, current SOC is triplet therapy for newly diagnosed; but too late for that. Have you asked about 2nd layer of ADT - Zytiga, Xtandi.....

[GP24]

You should add either Abiraterone, Enzalutamide, Apalutamide or Darolutamide to lupron. This is the standard of care for you. You could also get your bones radiated to mitigate the pain.

[Tall_Allen]

I think this would be a good time for Xofigo. Here are some good combinations to discuss with your oncologist:

prostatecancer.news/2021/02...

[Tinkudi in reply to Tall_Allen]

Xofigo is also for when one is still hormone resistant ?

[Tall_Allen in reply to Tinkudi]

Xofigo is only for those who are hormone resistant. Triplet is for those who are newly diagnosed as metastatic and hormone sensitive.

[Letsfish]

Thank you for the reply’s. My scans have stayed pretty much the same. Stable and similar to prior exams seems to be a common term in my CT and bone scans. I will discus these options with my doctor. Thanks again.

[fmh1]

Sounds like things are going well. I too, had six docetaxel treatments over 18 weeks, 44 months ago, still no detectable PSA. Only additions I had were daily Protectival tablet, three times daily, and the Care Oncology Protocol (CareOncology.com). Hope this is helpful!

[Boywonder56]

Add second tier.....erleada or such.....