Has anyone returned to the first line of HT after second line failed?

[tarzantass]

Question 1: I would appreciate anyone who can share their experiences about returning to the first line of HT (Casadox) after the second line (Xtandi) failed. If so, how effective it is. I was thinking that doing ADT alternatively can stop castration resistence. If it works for all of us like going back and forth, then we can all prolong our lives a little bit more.

Question 2: Is it true that Casadox feeds prostate cancer?

Question 3: Can wearing an iced hat or cap prevent from loosing hair (partially or completely?) while doing chemo (docetaxel)? Also can putting on iced gloves and slippers prevent numbness or tingling while doing chemo?

Thanks.

[GP24]

1) Xtandi is a Super-Casodex. Therefore it does not make sense to take Casodex when Xtandi fails. You could try Zytiga or Pluvicto.

2) When Casodex starts to fail the cancer cells have mutated so they can feed from it. Before that it works well.

3) Yes

[tarzantass in reply to GP24]

Thank you so much for your feed

[Magnus1964]

As to your first question, each ADT drug works differently. So going back to a drug after it fails "usually" does not work, unless you are resenitized to it with BAT or chemo.

If xtandi is failing, move on to zytiga.

[tarzantass in reply to Magnus1964]

Got it. Thanks

[tarzantass in reply to Magnus1964]

So it is workable after the chemotherapy (Docetaxel), right?

[Magnus1964 in reply to tarzantass]

Possible, some have had success with this.

[Tall_Allen]

1. If it is resistant to Xtandi, it is resistant to Casodex and probably to all other antiandrogens as well

2. Yes- if antiandrogen resistant, your cancer can probably feed on Casodex

3. Yes

[tarzantass in reply to Tall_Allen]

Understood. Thanks. How about the rest of ADT like Xtandi and Zytiga ? Will the cancer feed on Xtandi and Zytiga as well?

[Tall_Allen in reply to tarzantass]

Not usually, although cases have been reported. They are always stopped.

[tarzantass in reply to Tall_Allen]

Thanks

[Magnus1964 in reply to tarzantass]

Being resistant to one ADT drug does not mean you are resistant to all. I am LIVING proof of that.

[tarzantass in reply to Magnus1964]

Thank you so much

[spencoid2]

just to answer question 3. I did not ice my head or any hairy body parts and hair all fell out or got very thin. I iced my feet until it became too much of a bother with the ill fitting booties. I iced my hands through all 10 sessions of doxy. I have had very minimal peripheral neuropathy so it might have helped but not everyone gets peripheral neuropathy without icing. Hands are pretty easy if you can find ice pack mitts that fit. I had to make my own as the stock ones did not fit. Someone on this list suggested just plain old ice for the hands and feet. I wish I had thought of that although it would be a bit messy.

[tarzantass in reply to spencoid2]

ok thanks. So your head hair didn’t completely fall off, right?

[spencoid2 in reply to tarzantass]

it got very thin so i shaved it off. did not want peach fuzz. now it is starting to grow back as what looks like normal hair but too soon to tell, it is just 3/16" long my face hair including eyebrows and eyelashes are still almost completely gone as are my underarm and pubic and chest hairs.

[tarzantass in reply to spencoid2]

thanks very informative

[Ramp7]

I can add some light to part of your question. After 18 months on Lupron and Zytiga my PSA was climbing. I completed a trial study with LuPSMA177. Mild success but PSA slowly rising. Met with Dr. Denmeade at Johns Hopkins. He said with my profile I would be a good candidate for a BAT trial. What I did instead was initiate my own BAT protocol. Denmeade also stated that after BAT looses it's effectiveness, the cancer can be resenzitised with the use of Xtandi. Then back to BAT. They do not know how many times this can be done. More studies are needed.

[tarzantass in reply to Ramp7]

Thank you so much

[TN1932]

I wonder if one can alternate between Casodex and Xtandi while they are all still working in order to hopefully prolong the time being castration sensitive???

[tarzantass in reply to TN1932]

what I was saying is Xtandi I am using is starting to fail. If this is so, can I return to Casadox Thanks for your feedback

[Ramp7]

Check out the term Adaptive Therapy. Makes sense.

[tarzantass in reply to Ramp7]

OK. Thanks