PSA and Images all stable for 4.5 years.

[pdold]

Tired of the side effects so with OK's from both of my MO's I started a vacation. Lupron and Zytiga stopped until either chemical or image progression shows up. The goal is to rebuild the lost muscle and possible lose some of the other SE's -Fatigue and brain fog being most annoying. My question is about backing off from the 5mg Prednisone that I've used for almost 5 years. Suggestions?

[6357axbz]

these were my mo’s instructions for dexamethasone taper off:

Directions for tapering: Please take half a tablet daily for 1 week, then half a tab every other day for the following week. 

I would imagine same would apply to prednisone

[Tall_Allen]

Follow doctor's instructions. Slowly is better. Always take with breakfast. One doctor I respect recommended:

first week: Mon (5 mg) Tues (2.5 mg) Wed (5 mg)...

second week: Mon (2.5 mg) Tues (2.5 mg) ....

third week: Mon (2.5 mg) Tues (0) Wed (2.5 mg) ..

fourth week: 2.5 mg on M Th Sun

If you get any of the following symptoms, increase dose slightly: fatigue, dizziness (especially upon standing), nausea, fever, weight loss, muscle weakness, joint pain, and mood changes.

[tango65]

This is information from up to date, the most reliable place for clinical medical info in internet:

""Two randomized trials recommended a variant of tapering by skipping more days between doses but keeping the dose unchanged (eg, 7.5 mg every other day for two weeks, then every third day for two weeks, then discontinued). Another study decreased the prednisone dose by 1 mg every four weeks at doses below 5 mg daily.""

Since he has been in Prednisone for 4.5 years, the slowest weaning option is probably the most prudent. Besides abiraterone also causes its own atrophy of the suprarenal glands since it inhibits the production of steroids hormones except for aldosterone.

[Gearhead]

I've read your post with great interest. I've been on Lupron and abiraterone +prednisone for 4 years, PSA has remained <0.1, and images show now progression of my one bone met. The cumulative ADT SEs are getting to me, especially muscle loss (in spite of regular gym workouts), and I fatigue so easily that it's embarrassing. Finally preparing to ask my MO for a vacation. So, please keep us posted about how your vacation progresses.

[GoBucks in reply to Gearhead]

Gearhead, I also am on a medication vacation. Last lupron shot was in December 2021. Last abiraterone swallowed June 3, 2022. Still <0.01 and I feel better although my testosterone has not recovered. Best of luck.

[Boywonder56]

Wish you the best...i think more than a few of us would like to do the same....poke the bear....

[Boywonder56]

I guess i should reitterate what my uonc said to me" you have an aggressive form of apc...THERE IS NO KNOWN CURE....all we can do is pallative care...put it to sleep.."....now when i ask can i get off this nasty shit for a break....he says " why".....wish i could give him 5 yrs of adt......bw

[Kayakbob]

Best of luck with your ADT 'vacation! After 3+ years of ADT, and worsening side effects. I pushed my MedOnc for one after my PSA had been unmeasurable for 18 months. He finally agreed, only if I agreed to go back on ADT once my PSA rose again (to over 10). Vacation lasted over 6 YEARS, until PSA started rising again. Now dealing with small mets again, so back on ADT (Orgovyx), Xtandi, and Pluvicto, trying to kill the beast! The vacation was well worth it for QOL. 😎

[KocoPr]

Hi kayakbob, hope ll is well with your pluvicto infusions.. by the way how are the pluvicto infusions going? How many so far and psa results?

[j-o-h-n]

As that young female told you the first time she had sex..... "Now, easy does it".....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/21/2023 5:07 PM DST