To review, after 19 months on Lupron, Zytiga, prednisone, PSA increased on 1/23 to 0.253, then 0.309 on 2/21. Plarify scan showed only one active site in hip which was radiated. 4/4 PSA dropped to 0.24 which indicated the lesion was knocked out and I would be hormone sensitive and stay on Zytiga. Yea ! HOWEVER, 5/23 PSA went UP to 0.343 and 8/4/23 now 1.46 at my PCP physical. Have MO appt 8/16 which includes another PSA check but looks to me like another PET scan and/or Xtandi. I would appreciate any thoughts from all of you to better prepare me for my 8/16 appt.
8/4/2023 Update: To review, after 1... - Advanced Prostate...
8/4/2023 Update
I am NOT expert on any of this but my observation about MDT from so many patients on here indicates that once you radiate, in the beginning, the psa goes down then new Mets appear someplace else and psa starts to rise. I have no explanation for this nor I have trials but I noticed that. I am not sure why is that. It’s just an observation and hope the experienced folks can elaborate on this. Obviously I could be be very wrong.
Hello,
There have been many posts over the years that have indicated switching from Zytiga to Xtandi or vice versa only works for a short time. The two drugs have different mechanisms of action and, from what I have read, Xtandi (enzalutamide) is considered slightly better than Zytiga (abiraterone) at treating metastatic-castration-resistant prostate cancer. After five years on Xtandi, I was switched to Zytiga as part of a clinical trial. I never expected Zytiga plus Prednisone to last very long but I am approaching a year on Zytiga and touch wood it is keeping my PSA reasonably low. It was 1.2 in July. My experience goes to show everyone is different and nothing is for sure. Good luck!
My MO suggested that I try Xtandi a few years back but when I saw the cost of it, I had to decline and stayed on Zytiga. My copay on the Xtandi would have been over $1500 per month, my Zytiga costs me only $ 163 a month. Just wondering how much you were paying for the Xtandi if you don't mind sharing. Glad your PSA is stabilized!
Hello,
I live in Canada and the Cancer Agency and our provincial medical plan pays for drugs like Xtandi and Zytiga.
WOW! That is a great benefit. Have you had to have any surgeries? I have heard that it takes a long time to get scheduled to get any cancer or cardio surgery in Canada
I get drug coverage thru The Assistant Fund (TAF). Zero cost. Did your MO want the switch because Zytiga failed. Hopefully it is still working. I have MO appt next week and may face that choice.
The reasoning was that my PSA had started to slowly creep up with the Zytiga and a Clinical Study was starting up using Xtandi and the doctors wanted me to join the group. The problem was that I would have to pay for the medication. Not sure why but that is how I found out about the cost of Xtandi. I am still on Zytiga and it is working still.
It sounds like it's time to bring out the bigger guns- and fortunately, there are several to choose from and possibly combine: Taxotere, Xtandi, Xofigo, and Provenge.
prostatecancer.news/2021/02...
What about another scan and radiation (whack a mole)
Sorry to hear that. I just started on Lipton and abiraterone and steroid. Good luck. Pluvical?
Two years ago, I was in the same boat. I enrolled in a trial study at Dana Farber, LuPSMA177. I responded but it was not durable. Met with Sam Denmeade at Johns Hopkins regarding BAT. He thought I would be a good responder. I am. Presently on a BAT protocol, improved QOL and cancer is stable. urotoday.com/video-lectures...
Switching to xtandi or Casodex might be a good move.
My belief is that tumors can grow arms like an octopus and so a precise radiation treatment might eliminate the body of the tumor but then the arms grow. Your PSA then grows in proportion to the size of the new tumors.
youtube.com/watch?v=LCRZZC-...
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 08/05/2023 1:38 PM DST
I would agree with your medical oncologist, since there is increasing PSA levels, a PET scan will help in detecting the new site of disease if any and if it found to be positive then treatment can be planned accordingly.