Patient
68yrs, male, bedridden for 2 years because of metastatic cord compression from advacnced(stage 4) prostate cancer. Taking Zolodex 10.8 every 3 months for last 2 years with some regular tablets like hypertension, multivitamins etc.
First time in 2 years PSA is starting to go up, so wanted feedback. Overall physical condition is largely same and no visible changes/deterioration.
A one time rise of 0.91 isn't reason to panic. If his PSA continues to rise, it's a cause for concern.
Thanks much for the quick inputs.
Hello,
It looks like you are ready for Tier Two ADT drugs. Where I live the options are Xtandi (enzalutamide) or Zytiga (abiraterone) plus Prednisone. There are other options as well. If you don’t have a medical oncologist, then you need to get one soon. He or she will work with you to develop a plan. Take your wife or a family member with you when you see the oncologist and have them take notes. Good luck!
We live in India and have an oncologist. There are generic equivalents for zytiga and xtandi here, will ask our doctor.
Originally the doctor had given a survival of 2-3 years and said that once PSA starts going back up we need to be cautious. So i was studying to panic if something bad was about to start happening.
"First time in 2 years PSA is starting to go up" That is not a real increase yet. Just keep monitoring as you've always done.
Thanks Allen. I was thinking in %ge terms and was worried that it went up 20%. Good to know this isn't bad news.
Should we now start testing more frequently? Right now we do once in 3 months and time it to be a month after the zolodex injection.
You could get Spine Decompression Surgery. This could make you no longer bedridden.
We got the spine decompression done rightaway(in about 3-4 days) since they had to do tests, get his sodium levels corrected etc but even though the surgery went well, my dad hasn't regained the ability to walk. The surgeons told us that the chances were very low even before the surgery but we still went ahead hoping it might magically work. What the doctors said was that once the spine is completely impacted for more than a day, by tumor or otherwise, its very hard to gain back the function.
The oncologist also mentioned that given he is bedridden they don't want to do certain medications(not sure if zytiga is part of it) including chemo since he isn't walking yet. Their rationale is that it will impact quality of life while improving survival by just a few months.
UPDATE
Met our uro-oncologist today. He asked me to come back in 6 weeks with another PSA test, if there is a rising trend he said he will add abiraterone. Additionally, he said will evaluate my dad, add some bone strengthening injection and also some palliative care. He also mentioned that Zolodex works only for 2 years in general, so it's time for the next medicine.
I have been drinking cold pressed beetroot juice & it’s shrinking my prostate as the red pigment in beetroot has powerful antiiflamation properties & pain has reduced considerably
Just got the next test done yesterday and it seems to be on an increasing trend.
Last month, oncologist had said that he will start Abiraterone in case the trend is increasing and also that he needs to see the patient once.
Does Abiraterone have any significant side-effects? My dad has been completely bed-ridden for over 2 years now.
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