Zytiga

[Poollover]

I've now added Zytiga-1000mg about 3 weeks ago and it has brought my PSA down to .98 from 1.8 with only Orgovyx. Is there anything I can do to bring it down still lower, ideally to an undetected level? Poolover

PS I'm 86, stage 4, Gleason9.

[6357axbz]

you need to provide more info. RT? RP? Mets?

[Poollover in reply to 6357axbz]

I'm 86, Gleason 9 stage 4, already on Orgovyx and Zytiga, which brought my PSA from 72 to 0.98. I'm quite healthy for my age. Also, want to consider proton beam therapy.

[6357axbz in reply to Poollover]

So no radical prostatectomy, no radiation therapy to your prostate? Do you have any metastices? If so where?

[HikerWife in reply to 6357axbz]

He is stage 4 - equals mets.

[Poollover in reply to 6357axbz]

lots, neck spine hip.

[dhccpa in reply to Poollover]

How many distant Mets, and where are they?

[Poollover in reply to dhccpa]

I look like a Xmas tree; too many to count. But most are small.

[treedown]

It may keep dropping. Give it some more time.

[Poollover in reply to treedown]

I hope so: Orgovyx brought it to 1.69, but then a month later it went to 1.79, which is why I pushed for Zytiga.

[Mike1971]

In clinical trials, significant PSA reductions were observed as early as two weeks after starting Zytiga treatment, with maximum reductions typically occurring within the first few months of treatment.

quickrxspecialty.pharmacy/a...

[6357axbz]

Stage 4a includes both sides of prostate and possibly some near metastices, this cancer can be curable. Stage 4b includes distant metastases like bones or distant lymph nodes. Not curable.

[Amadeus71]

I started treatment January 2022, 30 days of Casodex, zytiga + prednisone, monthly lupron and Xgeva injections. PSA high was 186 just prior to that, and within just a few months PSA was below 1. I made the change from lupron to orgovyx in May of 2022. PSA steadily declined, and finally undetectable in April of 2023. In addition to initial meds, I changed my diet to primarily plant based, exercise more often (daily), added daily metformin in August 2022. Changed Xgeva to 60 days in January 2023. Had SBRT of prostate and lymph nodes in April 2023 then another round of SBRT in December 2023 to treat pelvic bone, femur and spine mets, all of which were detected back before treatment started. Still taking zytiga + pred, orgovyx, and Xgeva. Still undetectable.

[dhccpa in reply to Amadeus71]

Great results!

[jackwfrench]

My MO won’t endorse a change to Orgovyx due to brevity of proven results vs Lupron -though I am impressed with less SE and improved potential for going Adaptive- what was your rationale for the change?

[Amadeus71 in reply to jackwfrench]

Recommended by a couple of my docs. Fewer/ less intense se, and potentially faster return to "normal" if/when taking a vacation. I can say that hot flashes were fewer, farther between, and less intense on orgovyx.