Last chance saloon or what?

[konichiwa12]

My most recent PSA score went up to 9.04 from 2.45 in March, 2.14 in January 1.05 in November and it was 0.61 in August. I finished Docetaxyl chemotherapy on 7th Septemb er last year so I've only been on Prostap with prednisolone since then. My onco says he will arrange urgent bone scan and full body CT scan then go to be assessed for clinical trials. My experience is that clinical trials do not have a good success rate so I am sort of telling myself that this could be the start of the end! Has anyone any experience to refute this? 🤷‍♂️

[BoiledFrog22]

Sounds early for clinical trial to me, but it depends on the healthcare available to you where you are. There are various second line hormonal treatments and alternative chemo courses available. Examples from the prostate uk pages prostatecanceruk.org/prosta...

Abiraterone (Zytiga®) tablets are most commonly given to men with advanced prostate cancer that’s stopped responding to standard hormone therapy. But some hospitals now offer abiraterone as a first treatment for advanced prostate cancer, for example if a man isn’t fit enough for chemotherapy.

Enzalutamide (Xtandi®) tablets may be offered to men with advanced prostate cancer as a first treatment in combination with other treatments, or if your cancer has stopped responding to other types of hormone therapy.

Darolutamide (Nubeqa®) is a new type of hormone therapy. It won’t cure your prostate cancer, but it can help keep it under control. It has also been shown to give some men longer before their cancer spreads to other parts of the body (advanced prostate cancer). This is being added to standard care in the UK - ADT, Docetaxel and Darolutamide from this summer.

Apalutamide (Erleada®) tablets may be offered to some men with localised prostate cancer or locally advanced prostate cancer that has stopped responding to other types of hormone therapy, but has not yet spread to other parts of the body (advanced prostate cancer).

[konichiwa12 in reply to BoiledFrog22]

I have already had radiation therapy which eventually stopped working. I then had Abiraterone which eventually stopped working. Same with Docetaxyl. He (Onco) previously mentioned the possibility of Cabazitaxel but he wants to have the clinical trial assessment first. I have already had a Foundation Liquid Biopsy in 2020 which found no appropriate genomic match.

[BoiledFrog22 in reply to konichiwa12]

Sorry, didn't realise you had tried those. is radium 223 (or similar) an option for you? You can't have it at the same time as Abiraterone but possibly can if you have stopped

[Tall_Allen]

In the US, there are several medicines you haven't tried that have already proved themselves in clinical trials: Pluvicto, Xofigo, Jevtana, Provenge, enzalutamide, and PARP inhibitors if your tumors are BRCA+.

[Ramp7]

Failed Lupron/Zytiga, Completed LuPSMA177. Chemo naive. Now doing "BAT" with positive results, improved QOL. You are not at the end!

[JoeyDad]

I don’t know the answer but isn’t Pluvicto a possible next step?

[konichiwa12]

Food for thought, thanks everyone!😃