Decision Xtandi or radiation

[alperk]

Many posts proceed this one and I am now at a crossroad. Scans since 7/21 showed uptake in either/or illiac, acetabulum and the ischium. After 2/23 scan I had 35 gys radiation to acetabulum. PSA dropped then started rising, 9/23 scan showed SUV uptake 28.4 at ischium. PSA 4.2 Local radiologist is concerned that radiating ischium close to the acetabulum could cause bone damage. The guy who did the original (who I really trust) feels the radiated acetabulum is far enough above the ischium so no problem.

The other option is replace Zytiga/Prednisone with Xtandi which I resist since Z/P is controlling all the other lesions and Xtandi can be used later if neecessary.

OK, so its radiation or drug change. What do you guys think? I see MO Wednesday to make decision.

[raoulmaher]

Hi Raoul here in the UK - I did radiation first then on to xtandi and Goserlin ( 3 monthly ) an I can wee again fairly normally - sweats have finally almost dissapeared - Have found that Vitamin D3 with K2 appears to lessen any headaches that I get fairly frequently and NO viagra does not help - No sex here - No alcohol either - but still alive ! PSA 0.03 and all other readings ok - I hope that helps kindest Raoul

[treedown]

If radiation can be performed safely I personally would go that route based on my current condition after quite a lot of it. I trust my RO as he recently decided against it for safety reasons. So I feel he won't proceed when unsafe. But there are risks to all of these treatments so once decided don't look back.

[Flathead]

I just passed that crossroad. 14mos Zytiga/Pred, numbers started up, cold turkey on both for three weeks, now difficulty walking, left hip, NOT sciatica, started Xtandi/Talzenna four weeks ago, started rad on left iliac to pelvis three days ago. Walking difficulty almost gone.

So far, so good

[Leader4077 in reply to Flathead]

I would like to mention early chemo which is being used in more places than 10-20 years ago. It is NOT a last gasp Hail Mary. I had my 17th infusion of Docetaxel today spread out over 2 and a half years. It lowered my PSA EVERY single time, 10-15 points at a time. Hemoglobin, red blood cells, platelets,ALP liver scores really need to be watched but just as important is the neutrophil/lymphocyte(sp?)ratio.

Good luck

Mike in Seattle

[Jbooml]

If primary ADT has limited effect on markers and scans it seems other T blockers aren’t necessarily your next best choice. Cast the net widely, be thorough in your research but don’t be afraid to look afield for other widely successful tools.