Switching from Abi to Enza?

[Rodeoz15]

Hi everyone, my father has been taking Abiraterone since 2.5 years now (along with prednisolone 5mg). It has nicely brought down his PSA from 500 to less than 1 and kept it steadily less than 1 since the past one year. He, of course, takes Lupron alongside. However, Abiraterone has resulted in some side effects, the major one being increase in blood sugar levels. My father has become pre-diabetic now and the doctor has advised to switch to Enzalutamide as it has fewer side effects.

I wanted to check if anyone else did something like this (switching to Enza when Abi is still working), and whether you think this is a good idea?

Many thanks in advance.

[Magnus1964]

I might try stopping the Lupron first and see if his blood sugar levels come down. If aboraterone is working try to stay with it.

[Hidden in reply to Magnus1964]

Lupron is the primary, Abi is the secondary med.

If he's pre diabetic, he should start with Metformin, and a revised diet. Metformin has a dual benefit.

Enza is best when Abi fails. Do not switch to Enza while Abi still works.

[Magnus1964 in reply to Hidden]

I did switch to xtandi after aboraterone. I'm just trying to point out that burning through a lot of treatments is not advised.

[Tall_Allen]

Lupron itself, may change blood sugar levels. I'd hate to change from abi that is working so well for him. Ask about Pioglitazone (30 mg). Ask Wassersug if estrogen has the same effect on insulin resistance as Lupron.

[Hidden in reply to Tall_Allen]

Of course not.

Metformin, and a diet change will bring pre diabetes under control. This keeping his PCa meds alone.

[Tall_Allen in reply to Hidden]

"Of couse not"? Estrogen doesn't increase insulin resistance? Do you know that for a fact?

[Hidden in reply to Tall_Allen]

Response meant Magnus1964., not you , sorry

[Hidden in reply to Tall_Allen]

Neither my PCP, nor endocrinologist will even consider Pioglitazone.

[Tall_Allen in reply to Hidden]

Yet that has been the subject of a proposed clinical trial.

[Hidden in reply to Tall_Allen]

Cardiac issues.

Im already taking so many drugs with heart related SEs, they dont want to compound!!

[Warrior13]

I’m also taking Zytiga and prednisone. I wish your dad the very best, I’m curious as to what other have to say as well .

[Benkaymel]

Everyone responds differently to drugs. Both Zytiga and Xtandi have SEs and the best for you depends on your response. I've never had Zytiga but after a year on Xtandi my SEs have been minimal - just the usual ADT ones (hot flushes, fatigue, muscle tone loss all due to low testosterone). Best way to counter them is regular exercise and good diet.

[Amadeus71]

I'm on Orgovyx, Zytiga and prednisone since early 2022. Added metformin about 6 months ago. All numbers have been good/steady.

[Professorgary]

magnesium and curcumin while on adt. Google it. Increases insulin sensitivity and decreases blood pressure and lipids. Also google both supplements for the treatment of Pca.

[j-o-h-n]

I agree......We all are different except we all have Pca.........

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 09/14/2023 7:52 PM DST