what if I stop taking Zytiga?

[OldGuysRule]

Diagnosed about 14 months ago with metastasis to spine and prostate bed. Started Lupron and Zytiga w/ prednisone.

I have seriously struggled staying on Zytiga. The usual side effects are bad enough but three months ago my blood pressure spiked to 222/110 sending me to the ER. I’ve never had high blood pressure before this episode.

My oncologist lowered it by half to 500 ml. I’ve been fine until two weeks ago it spiked again. I have stopped taking Zytiga all together and feel much better. My oncologist tells that any replacements to Zytiga will be more harsh as side effects go.

At this time I am on Lupron only. My numbers have good on both meds. My question is, what if I just take Lupron only? 🤔

[Tall_Allen]

Lupron-only will reduce your expected life by about 40%, and bring on castration-resistance and painful metastases faster.

Sometimes BP spikes if there is not enough prednisone. Or you can try switching to enzalutamide (Xtandi) or apalutamide (Erleada).

[OldGuysRule in reply to Tall_Allen]

I will discuss it with my Onc. Thanks

[Papa1 in reply to Tall_Allen]

Talk to your PC doc about blood pressure drugs. If you are on 5mg of prednisone, try upping to 10mg. That worked for me. Yoga and other exercises can help with bp. Don’t give up on abi, it’s keeping you alive.

[GrantB47 in reply to Papa1]

I thought abi/pred simply gave one a 7% greater chance of survival which is already pretty darn good on Lupron alone. Is this not the case? I do already have HBP but had to stop the Abi/pred because of a severe cough. The cough still has not completely disappeared and I cannot find anyone who knows anything about it being a side effect. Am I killing myself by stopping the abi/pred?

[Papa1 in reply to GrantB47]

I can’t talk percentages, but your pc will advance more rapidly on Lupron alone. Never heard of cough as a se of adt. See your pc doc pronto.

[GrantB47 in reply to Papa1]

Thanks for the response. A cough is listed as a side effect of the abiraterone and my doctor endorsed the halt and did not suggest lowering the dose as an alternative.

[Tall_Allen in reply to GrantB47]

You are sadly mistaken. Abi decreased mortality by 40% over Lupron alone.

ncbi.nlm.nih.gov/pmc/articl...

[OldGuysRule in reply to Papa1]

Thanks, I will

[gsun in reply to Tall_Allen]

I was taking 10mg of prednisone and my BP was high. My doc said to lower the dose to 5mg and that lowered my BP to normal. Exactly the opposite of what you are saying.

[Gearhead]

Sometimes changing the prednisone dose or replacing prednisone will reduce hypertension associated with abiraterone, e.g.:

a) Increasing prednisone from 5 mg to 10 mg per day (assuming you are castrate sensitive and currently on 5 mg per day).

b) Replacing prednisone with dexamethasone.

c) Replacing prednisone with eplerenone.

Searches on this board will find more on these possibilities and the associated biological mechanisms.

[OldGuysRule in reply to Gearhead]

Thank you!

[Concerned-wife in reply to Gearhead]

I have read interesting studies about c above. My husband did great on abi until about the same time period. He managed to stay on for two years and now specialists from two centers of excellence have agreed to, even suggested a vacation fro it and Lupron..his PSA has been Undectable

[Scout4answers in reply to Concerned-wife]

Reading through your husband's Bio... what was his Gleason score?

I have a similar diagnosis detected about a year later.

[Concerned-wife in reply to Scout4answers]

8.

[Scout4answers in reply to Concerned-wife]

I will watch his vacation with interest

[Concerned-wife in reply to Scout4answers]

We are, too! Another good lab result yesterday. Labs every three months. It is predicted that his cancer will return but he feels so good now and he figures the drugs will work again.

[Nfler in reply to Concerned-wife]

With or without ADT

Great option to keeping your psa low

[Concerned-wife in reply to Nfler]

Without

[StayingOptimistic]

I have been on Erleada for about 6 months. No side effects so far.

[BruceSF]

some people are helped with side effects by reducing the dose to 250 mg (1 pill) a day taken with a light, low fat meal (like toast with butter or berries and yoghurt). There’s a good discussion on this site at healthunlocked.com/advanced...

It might be worth a try if you can’t switch to erleada.

[Radtech40]

For that reason my dad was put on Xtandi and only experiences some fatigue, bp is good now, maybe see to switch to Xtandi.

[OldGuysRule in reply to Radtech40]

Thanks

[nextphase]

I've been on lupron now for over two years. My psa at this time is undetected. Normal side effects nothing I can't deal with. I had robotic surgery in 2008. That's all I can share for now. Keep working out as much as you can tolerate it helps to keep some muscle.

[dmt1121]

I was prescribed a blood pressure medication when my BP rose after starting Zytiga and that worked to allow me to continue taking Zytiga.

[j-o-h-n]

And some "OldGuysDrool"

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/02/2023 10:02 PM DST

[Professorgary]

Curcumin and magnesium both lower blood pressure naturally however it takes 4 to 8 weeks to reach full benefit. Consult with your oncologist first. I take 450 mg of magnesium and 2800 mg of curcumin daily. Bb is now 130 over 80 midday and about 115 over 75 in the evening. Curcumin relaxes blood vessels and magnesium acts as a calcium channel blocker.

[Bspouse]

Hi , my husbands BP is often 160 or even 180 / 90 on abi and lupron. MO doesn't seem worried but we are concerned that it is too high. It is always higher at the Dr office (knowing the lupron shot is next) but prior to cancer, his BP was always normal. He does take curcumin daily and has started drinking beet juice. We could add magnesium. But do you think he should be on meds to lower BP? He is scheduled for hip replacement surgery in a few weeks.

[OldGuysRule in reply to Bspouse]

I’ve been on Lupron and Zytiga over a year now. I’ve never had BP issues at all. The Zytiga drives my BP high even crazy spikes like 221/111. We’ve lowered the dosage but still it goes high, just not as high. I just started on BP meds for the first time in my life. It makes me sad to keep adding more medications. That’s where we are.

[Bspouse in reply to OldGuysRule]

Agreed , we hate to add more medicines ( with more side effects). He is going to a cardiologist to get cleared for the hip replacement - I dont know if they will insist on BP meds or not.

[OldGuysRule in reply to Bspouse]

I wouldn’t be surprised. May God bless both on your journey.

[Nfler in reply to Bspouse]

works well with or without ADT

Great option keeping psa low

[Nfler]

If the bp keeps high n you can’t tolerate the zytiga like I didn’t, then incorporate ivm as its safe n keeps lupron or better yet orgavix from being castrate resistant by recent studies and keeps psa extremely low… good luck 🍀