Symptoms when ADT no longer works?

[SandyBear2023]

Hello, everyone! I have begun year two of stage 4 metastatic prostate cancer and I have BRCA2. Taking abiraterone + prednisone daily and Lupron shots twice a year. I am doing my best to live one day at a time but wonder what things will look like when the cancer becomes resistant. Does anybody know?

[Tall_Allen]

You will probably move onto any of several other therapies (including PARP inhibitors).

[SandyBear2023 in reply to Tall_Allen]

Thank you so much. Someone mentioned your name to me in a FB group.

[tango65]

The cancer will progress..

There is a PSA increase and then when there is evidence of radiographic progression of the tumor the therapy has to be changed.

ADT will continue.

The usual following step is doing chemo, but in you situation with BRCA mutation, they could consider to do Olaparib or rucaparib or a clinical trial and to try enza plu talazoparib or other "ïb" drug before doing chemo.

[Magnus1964]

Just because you failed Lupron and Zytiga does not make you castrate resistant. There are other ADT drug options.

[addicted2cycling in reply to Magnus1964]

No ADT drugs for me 'cause I just cut out the little boys 😀 by having an Orchiectomy in 2015.

[Magnus1964 in reply to addicted2cycling]

An orchiectomy does not exclude ADT drugs. I had an orchiectomy, my PSA started to rise after four years. I started casodex and it brought my PSA back down. When casodex finally failed (5 years), I went on the Zytiga, then Xtandi. 30 years later, I still here.

[addicted2cycling in reply to Magnus1964]

In agreement and understood from the beginning since I'm GL10 and still have half a prostate left thanks to my Euneek(uch) surgery and experimental immunotherapy treatment so reply was a bit of Orchieeee humor 😀😀

[j-o-h-n in reply to addicted2cycling]

So reply was a bit of Orchieeee humor, Yep..... like juggling balls........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/23/2023 2:35 PM DST

[addicted2cycling in reply to j-o-h-n]

Balls were too big and heavy to juggle and got in the way of comfortable bicycling so just went a bit lower than "Off with His head"

[j-o-h-n in reply to addicted2cycling]

NO!!! NOT THE HEAD!!! Tell me that ain't so............That little head has been my Helmsman all my F**king life...... and I do mean **.............

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/23/2023 3:10 PM DST

[deepika_agnihotri]

If your cancer becomes resistant to the hormonal therapy, then radionuclide therapy (Pluvicto, Lu-177 / Ac-225 PSMA therapy; 01st and better option) and chemotherapy (Enza.) are the options available to you.