Time to adjust my course, any suggestions?

[rick8637]

Psa is on a steady increase again. I was taking extandi for a year up until 11 /23 over that yr my Psa had dropped from 29, 11/22 to 1.4 ,11/23. I was having significant SEs, brain fog mainly so I decided to switch to nubeqa (daralutimide) even tho there was a steady drop in PSA on extandi. Nubeqa was a breath of fresh air but now it appears i made a mistake to switch. after 3 months on nubeqa psa increased to 2.6on 2/24 and now5.6, on 5/24. I have also been on orgovix for 1.5 yrs now.

So .. My first thought was to go back to extandi because it was working and try to deal with the SEs.? Do you think there is a possibility of it working again? Another choice would be docetaxel. I understand that with increasing PSA the docetaxel may be effective. I have never used any chemo drugs. Looking for some wisdom from the clan here as i read every post daily and there is a world of knowledge here.

I have an appointment with my MO next week so I need ideas to plan a course. I appreciate all of you!

[God_Loves_Me]

probably you know Xtandi and Nubeqa are from same class means MO may tell you if you fail Nubeqa means Xtandi will not work because cancer is hormone resistant.

Overcome from hormone resistant mostly MO suggest chemo. I think it is right way as well.

Please ask following questions. there is research out there combinations of Niclosamide and Bicalutamide help to overcome from hormone resistant of Xtandi or similar drug. Here is

Source link : ncbi.nlm.nih.gov/pmc/articl...

Keyword to search :

Niclosamide and Bicalutamide Combination Treatment Overcomes Enzalutamide- and Bicalutamide-Resistant Prostate Cancer

Please update us as well so I can update my note for future.

[God_Loves_Me in reply to God_Loves_Me]

Tall_Allen what’s your thoughts on this combination?

[Tall_Allen in reply to God_Loves_Me]

IDK why you care particularly about AR splice variants, and why anyone would use unproven and toxic (at least in current formulations) drugs like niclosamide. I can't see why you would offer such possibly unsafe and ineffective advice without clinical data.

[gsun in reply to Tall_Allen]

Because some people will not survive long enough for all the trials.

[Tall_Allen in reply to gsun]

Knowing that 99% of lab studies show no effect in clinical trials, and there may be toxicity that lowers survival, how does it help to know what works in mice?

[Tall_Allen]

You can combine the two, as in this trial:

prostatecancer.news/2022/10...

[rick8637 in reply to Tall_Allen]

Combine current nubeqa with docetaxel? Is that what you mean? Or nubeqa with extandi? I have trouble reading these test results.. I have no Aphinity for deciphering this data .. ignorance is me

[Tall_Allen in reply to rick8637]

Xtandi+docetaxel

[rick8637 in reply to Tall_Allen]

Any harm or advantage to adding docetaxel to my current mix of orgovix and nubeqa. I do have a month of extandi available if I choose to switch

[Tall_Allen in reply to rick8637]

Yes, there is harm in using docetaxel when your cancer is not actively growing.

[rick8637 in reply to Tall_Allen]

Would my PSA need to spike to the extreme or is the doubling rule sufficient or another criteria.. ?

[Tall_Allen in reply to rick8637]

PSA. PSADT and imaging are all important.

[dk73]

my husband did taxotere first, then zytega, later Xtandi. He returned to taxotere after zytega & xtandi quit working. He lost his hair, does have neuropathy but weathered the treatments well. I would recommend a port if doing chemo. My husband started his treatments in 2017 with surgery/radiation. He was 64. Now at 71 he is doing Jevtana chemo

[j-o-h-n]

My guess it's the M.O.s guess....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Mgtd]

I will call your guessing and raise you with my guess.

[rick8637 in reply to Mgtd]

Now I get it, noone knows the best answer! I may hold off on chemo till I am sure the cancer is growing. Can't wait for the MO s opinion

[Hidden]

You can try BAT probably now entering the CRPC phase.

[rick8637 in reply to Hidden]

I have explored Bat briefly and will consider this. Thanks so much

[WisdomSeeking in reply to rick8637]

Please read first this discussion about BAT: healthunlocked.com/advanced...

[Hidden]

My MD has been in contact with MDs. in UK concerning BAT, the opinion has changed from reluctance to a positive attitude. I will ask for contact info.