Zytiga failed, Xtandi next

[alperk]

2/21/23 blood test shows PSA went up from 0.253 to 0.309 Testosterone unchanged at 45 since 1/23/23 test. B12 260. MO ordered 2500mcg B12 which I read helps bone health, energy and red blood cells.

Pylarify PET scan shows numerous stable non tracer avid sclerotic osseous lesions on the CT portion of the exam favoring treated metastases. Nice, but new small focus within a lesion at the left acetabulum consistent with active metastasis. That lesion is scheduled for radiation next week. MO says the active hip lesion means the Zytiga is failing, at least at that one area only but recommends Xtandi and I am now hormone resistant after 19 months on ADT plus Zytiga/prednisone.

[David1567]

hello Alperk

Maybe ask your MO if you can try changing the prednisone to dexamethasone first before you give up on zytiga ? My husbands MO agreed to this so he didn’t blow through all the meds out there quickly. Also I believe Zytiga is better tolerated. Best of luck to you

[alperk in reply to David1567]

Thanks for hour comment. My MO won't prescribe since that combo is not FDA approved and Florida Cancer Specialists have no clinical trial. I finish radiation next week and got my blood work scheduled for April 5 to see if PSA has gone down. If not is Xtandi. My idea. I kind of feel that my team is humoring me but I am trying to buy as much time as I can. Aren't we all.

[alperk]

Update on "Zytiga failed". PSA went down to 0.24, 3 weeks after radiation of hip lesion. PSA just came in at 0.24. . It was .253 on 1/23 and .309 on 2/21. This is the result we hoped for and I plan to stick with Zytiga and prednisone not Xtandi. This is SOC for hormone sensitive where Xtandi is castrate resistant next step. Does that imply that, for now, I am still hormone sensitive ? If PSA goes back up that's another discussion.