LUPRON CASODEX FAILURE NOW WHAT

[billyboy3]

After 26 years, my combo IHT has finally failed. My psa started to go up while unicycle-a first, in November, pas rose to 8, since then and after a disaster of my cancer set up here, my pas has gone to 20. My testosterone has gone up from around 3 max to over 9 so no idea how or why this happened while on cycle. Out cancer specialists here refuse to change drugs unit test drops but cannot explain why it has gone up so much.

I know nothing beyond the IHT, so need help to list what drugs I should try to get on and whether I keep taking lupron and casodex if I get other drugs.

did have a scan using 18 back in Feb, showed bone mets all over so radiation oncologist refused to black me at all-which I found odd given hit the big spots, less to grow.

So, please send me your thoughts and recommendations as to what I should do. next, as waiting to die is not on my list just yet, if I get jump on a few more drugs and buy some time.

ok thans, /

[Ahk1]

I would think at this point you need to start ASAP chemotherapy and a second line anti androgen and drop the casodex. This is what I would do if I was in your situation. Obviously listen to your MO and not me.

[God_Loves_Me]

Here is my personal opinion; I do not see a bio under your profile, so I might not have accurate suggestions.

I would definitely go for 'Orchiectomy" and add Xtandi. If PSA starts to raise three times after 4 months, then understand whether for Chemo or Pluvicto

there is another strategy to start Xtandi with Orchiectomy and immediately find clinical trials that treat with systemic therapy

Important part is systemic therapy for cancer. It can be ADC, Immunotherapy, Chemo, Radiographic injections, or anything else that is available

[Tall_Allen]

It's time for bigger guns. Consider docetaxel+Xtandi:

prostatecancer.news/2022/10...

[billyboy3 in reply to Tall_Allen]

and drop lupron and casodex?

[Tall_Allen in reply to billyboy3]

Drop Casodex. You will always be on Lupron (or similar).

[billyboy3 in reply to Tall_Allen]

what if I start with Zytiga and Prednisone first? I am scrambling now as I get my next bad news Tuesday but psa is now at 20, test 8 so am in trouble now.

[Magnus1964 in reply to billyboy3]

I would not drop casodex. It may give you years low PSA and QOL. start with it alone. If it doesn't work move on to Zytiga.

[j-o-h-n]

My doc replaced the Casodex with Nubeqa and it's working (lowering my PSA to a low point just above my PSA 10 years ago). I'm still on Lupron.

Check with your Doc. BTW You beat me by 4 years (22 for me).

Good Luck, Good Health and Good Humor.

j-o-h-n

[Magnus1964]

You have done well on Lupron and casodex. I see no reason why you not do well on Zytiga. If Zytiga fails, go to xtandi.

[billyboy3 in reply to Magnus1964]

thanks, so take Predisone with it? 2 x 500 mg Zytiga and 2 x 5 mg Prednisone daily? start with what three months if I can buy it somewhere online??

[Magnus1964 in reply to billyboy3]

If I remember correctly, I took 5 mg of Prednisone with Zytiga. No side effects. It just replaced what Zytiga takes out of you.

[billyboy3 in reply to Magnus1964]

Thanks,

[Yzinger]

26yrs!!! Congrats thats awesome.

[Mbnm]

you are in Canada ? Abiraterone and prednisone should be free…i take 2 of each every day plus. Lupron every 3 months tho you shud best do what Tall Allen suggests

[VisorF9 in reply to Mbnm]

Thank you Mbnm. I appreciate your and Tall Allen's input and will follow up. So far 1 treatment with Xofigo and oncologist is as well continuing with Apalutamide and Trelstar for the present. PSA was 412 when I was diagnosed,