Father’s CRPCa Failed chemo (Cabazitaxel,Docetaxel) and Failed LU177

[Vishwa1890]

Father’s current Age: 78

At age 70, Diagnosed with Pca in 2015 after seeing initial PSA as ~ 270.

2015 - 2019 - BICALUTAMIDE - Failed

2019 - 2020 - Radiation- Ineffective

2020 Oct - 2021 October - Zytiga (Aberiterone) - Failed - PSA 98

2021 Dec - 2022 Apr - Docetaxel- Ineffective - PSA 120

2022 July - 2023 June - LU177 - 5 cycles - Effective PSA gone down to 18.

2023 July PSA started to raise 86 - stopped LU177. Failed

Drug vacation 2023 July to 2023 September - PSA rose to 269.

2023 Sep - 2023 Nov Enzalutamide Ineffective … and stopped due to severe side effects.

2023 Dec PSA increased to 357. Started Cabazitaxel on December 27, 2023. 2nd dose on January 16th, 2024 and 3rd dose on February 6th, 2024. Tolerated well except for symptoms like loose bowel, slight pain and weakness. Checked PSA on February 12, 2024 and it is 620. Shattered by this!!

Please advise. Do we have any treatment left?

[MJCA]

Hi

You only reference the PSA. I am sure your father must have had some PSMA PET scans. What do the scans indicate?

[Vishwa1890 in reply to MJCA]

Thanks for the question MJCA . He did have scans done. I must say that his scans are not as intense as his PSA results. They indicate metastatic PCa specifying some parts like lower back where it has slight increase and other parts where it decreased etc. But the report never said PCa is growing aggressively. Also, though he has pain, its still tolerable, and he is getting good sleep as well (except for frequent toilet visits). This is what makes me ambiguous about PSA readings

[Vishwa1890]

Nothing left? Please advise.

[KocoPr]

i am so sorry to hear of all the crap your father has gone through. Start looking at clinical trials and if he fails to qualify put in for “right to try” it s a law now.

fda.gov/media/133864/downlo....

[Tall_Allen]

Xofigo? Provenge?

[Vishwa1890 in reply to Tall_Allen]

No Tall_Allen , we haven’t tried that. Is that a chemo category medicine or ADT?

[Tall_Allen in reply to Vishwa1890]

Xofigo is a radiopharmaceutical. Provenge is an immunotherapy. They work well together.

[Vishwa1890 in reply to Tall_Allen]

Thank you! Will talk to the MO about it.

[God_Loves_Me]

225 PSMA Actinium

ascopost.com/news/march-202...

Also ask for clinical trial too

[God_Loves_Me]

webmd.com/prostate-cancer/p...

[Vishwa1890 in reply to God_Loves_Me]

Thank you.

[God_Loves_Me]

Xtandi has higher side effects than ask for nubeqahcp.com

[dhccpa]

We often hear that PSA is only a marker, while scans tell the real story.

What does oncologist say about rising PSA but stable(?) scans? Could there be some other cause?

[Vishwa1890 in reply to dhccpa]

Exactly!! He has scan scheduled for 2/24. Interesting to see what MO has to say.

[RodofGod]

Actual physical castration may be the only thing left...Has that been discussed.... Oncology should know if this might give him more time... My father did it and it gave him a resurgence in time... About an additional three or four years to get things squared away... Inevitability he passed as it was in his bones pre surgery...

Best wishes...

[robert570]

Xofigo is another treatment. Then there's clinical trials.