Hi fellow warriors
I would like to ask a couple of questions if possible.
I am currently on Zoladex and have been for about 6yrs, I have had radiotherapy and Chemotherapy in the early days
Is there anything else I can try before going onto Zytiga or Xtandi.
Also with Zytiga or Xtandi is one better than the other as far as life expectancy and does either have worse side effects.
Cheers & many thanks
Gary
Zytiga then Xtandi works longer than Xtandi then Zytiga
Thanks TA but in the UK we are only allowed to have one or the other on NHS unless it's changed over the last year.
NHS does not allow you to take the other when the first stops working?
Same as in Australia.
I wonder if I can buy Abiraterone from India it seems pretty cheap about £50 for 120 x 250mg tablets.
Actually it turns out to be a fake site, bugger 😜 either way it's twice that price in the UK.
The reason given is cross resistance, but it may also be cost related.
I believe you could start and pay privately for generic Abirateron in Australia and later you just switch to enzalutamide payed by PBS, but the generic Abirateron cost just under 1000 A$ for a month supply. I am not 100 % sure in all of these but strongly believe so.
Mabe you could start with Enzalutamide payed by PBS and later you could continue privately with generic Abirateron. (I am not sure if that switch would work oncologycly?)
Cross-resistance certainly occurs, but there is still a survival advantage in crossing over to other one.
thelancet.com/journals/lano...
I hope NHS changes their policy, especially considering that PRESIDE shows that concurrent docetaxel can extend time on Xtandi.
I asked my MO about this long time ago and he simply said No. He doesn't believe that it will work, at least not for long.
Hi TA I think if one fails within the first 12months they will put you on the other but if you have been on one for say 4yrs they won't put you on the other. Not 100% sure of time frames but something like that anyway.
I found Xtandi to be the easier and more effective
Hello,
It is kind of like Pepsi and Coke. There are supporters and detractors on both sides. With Xtandi (enzalutamide) you don't have to take Prednisone. I took Xtandi for about five years before switching to Zytiga (abiraterone) which I took for about a year. The Xtandi brought my PSA down in a hurry. The Zytiga kept it down. I personally preferred Xtandi but there are lots of people who prefer Zytiga. Good luck!
What dose of xtandi did you take
Hello,
Four pills @ 40 mg each. When I was on Xtandi I took four pills a day or 160mg. I was told at the time that was the standard Xtandi dose. I found out later that there are higher (and lower) doses. However, I was on 160mg for the whole five years I was on this drug.
you tolelrated the full dose well ? What side effects did you have ? Many say they could not tolerate full dose and switched to half.
Hello,
I had no problems with Xtandi, nor did I with Zytiga for that matter although the Prednisone was probably responsible for some ugly blood bruises on my arms and hands.
Why did you change to Abiraterone if you prefer Enzalutamide?
Hello,
Simple reason. It was becoming apparent that after five years the Xtandi was no longer working the way it should. My PSA was slowly climbing and my medical oncologist felt that switching to Zytiga was worth a try. The reason I came off Zytiga was that I was accepted into a clinical trial investigating the use of Lutetium pre-chemotherapy. The clinical trial folks wanted me to drop all ARPI drugs although they did allow me to stay on Zoladex.
my dad was on zytiga for a few years , no real side effects. I’ve been on Xtandi now for 7 1/2 years. I’ve experienced most of the side effects. Only real bad ones were the neuropathy when taking the wrong pain meds. My doctor can’t believe I’ve been on it that long and am doing good with it PSA at 0.05. Months
Have you Been on the full dose of 160 mg xtandi. What side effects did you feel ? Dad is 83 and has started on 80 mg xtandi. Wondering if to scale it up or not
Hi again, i would give the Xtandi some time before scaling up, it will build up in his system, 28days til steady state. I usually hit a wall about every 10.days and need to take off due to the side effects (80mg 1/2 dose, year 5 🙏)
Thanks 😊
What do you mean by hit the wall every ten days and need to take a break ? For how long do you take a break
Good Morning, As the medicine builds up in my body, I start to feel a bit unwell, so (with the MO's blessing) I take a day off, then restart the medicine. (Usually just 1 day). I'm on Lupron/Xtandi combo.
You feel this way also on 80 mg ?
Yes, my body is very sensitive to all cancer meds, antibiotics, imaging contrasts etc...
Well yes I’ve been on the full dose since I completed chemo. High blood pressure, cholesterol , interactions to pain meds. Doesn’t play well with opioids or fentanyl And of course muscle loss.
How much did cholesterol rise
Don’t remember just that the doctor put me on a pill for it.
From what I have read the name of the game is resistance. One can lower the resistence to the other, so one is given before the other. One might search studies on effectiveness when docataxel preceeds abi vs enza.
I don’t think getting opinions from people helps you much since we are all different. I took abiraterone and had the hypertension and liver enzyme elevations. Liver enzymes normalized over time and the hypertension was easily controlled. All other side effects were related to not having testosterone which will be the case with both drugs.
If you have bone mets 100% Zytiga. My father was switched to Xtandi first because he had glaucoma and I was really upset because I read studies about Zytiga being a little better to start. He failed Xtandi within four months and Zytiga didn't work. But the steroids made a huge difference in quality of life.
HelloI've been on Abiraterone Acetate 250mg 4 tablets nightly along with Prednisone 5mg.
Started Feb 2023, just stopped month ago because my blood pressure keeps climbing.
Also in Lupron shot 1 every 3 months that us supposed to end in December with last shot.
PSA had been undetectable for last 6 blood tests.
Side effect no one talks about is penis and testicles shrinkage.
Urologist says testicles should go back to original size but not the penis. So loosing 1 to 1 1/2 inches is supposed to be fine? So no sex life for the future. I was never told about these two important Side effects.
How about anyone else???
I was told. That is why I put treatment off until it was do or die. Psa got to 5664 and Mets everywhere and excruciating pain with two new compression fractures. Now I am alive enjoying a good life without sex but I’m 74 years old. I was diagnosed 24 years ago and started treatment two years ago. Losing your sex life at 50 is a big difference from losing it at 72. This is why some of us don’t have treatment.
Your an example of what I wonder my life would have been like if I had never taken that PSA test my GP asked me if I wanted 5 years ago. Bold move. Glad your doing well.
You just never know but it’s best not to second guess ourselves. I am not saying what I did was the correct move, just saying that is why some guys don’t get treatment. I’ve been criticized by a few here after I shared my 23 year battle with cancer a while back and a few months later a fellow warrior shared his 12 year battle with cancer. We both started Gleason 3+3. We are now at the exact same place. The only difference was he had SOC and I refused treatment. The mistake I made was I got lazy with my regimen. My second biopsy showed 97% of the cancer gone and I just slacked off. Big mistake on my part but I am starting that regimen again along with the ADT. God bless.
Sorry but a little house cleaning is in order.
It's NO longer Hi fellow warriors, it's Hi fellow worriers.
Good Luck, Good Health and Good Humor.
j-o-h-n
PARP inhibitor Olaparib, phase 3 study findings (PROpel)
MRI prior to HDR Brachy and HDR intensity.
PSA holding low!!
