Success with Erleada

[docbulldog]

I’m looking for a possible treatment that will not completely cause my blood work to get worse. Has apalutamide been successful to others.

[MJCA]

Hi,

I was on apalutamide for 5.5 years. It increased my level of hypothyroidism. I am always anemic, so I cannot say if the drug had any effect. In the beginning, I had nausea, but that eventually went away. I had to stop taking apalutamide because it started making me dizzy.

Best of luck!

[binati in reply to MJCA]

I'm on Nubeqa for almost 2 years. All my bloodwork is under control and minimum side effects. Not sure about Apalutamide.

[MJCA in reply to binati]

I tried Nubeqa for a month and I had too many side effects.

[Sailing-Todd]

My husband has been on Prostap and Apalutamide since his diagnosis two and a half years ago.

He was very metastatic (his femur broke) and Gleason 10. His PSA has gone from 1120 to undetectable. His bloods were all over the place at diagnosis but are now all in the normal range.

He has the usual ADT side effects, fatigue, hot flashes etc., but is managing to get on with his life. His doctor is very pleased with his response. Hope that helps 😊

[Lost_Sheep]

This is not FDA-approved, but estradiol was shown to be highly effective back in the 1940s. Unfortunate side effect of oral administration was cardio-vascular problems of a major sort. But estradol (E2 trans-dermally or by injection bypasses the digestive system and does not have that any more. It has been shown to be as effective as Lupron.

The PATCH trial now stands in a similar pivotal position as Lupron in 1985 in the management of metastatic prostate cancer by providing an equally effective option as Lupron for lowering testosterone and treating disease. The PATCH trial results were reported in abstract form at the 2024 conference of the European Society for Medical Oncology by Dr. Langley, the principal investigator. PATCH (“Prostate Adenocarcinoma Transcutaneous Hormone”) study.

The report concluded:

- At 3 years metastasis-free survival was the same for both agents ~86 to 87%. Overall survival was similar over 14 years of follow-up.

- The adverse effects profile favored tE2, reducing hot flushes from 89% (Lupron) to 44% (tE2). At 2 years bone mineral density improved by 7.9% ( tE2) vs. a -3% worsening for Lupron. This change occurred rapidly over the first year. tE2 provided an improved quality of life.

- Cardiovascular adverse effects (heart failure, angina and myocardial infarction and thromboembolic strokes) were similar, about 7-10% . However, gynecomastia developed in 85% (tE2) vs. 44% (Lupron). Prophylactic low-dose radiation to breast tissue lessens this development.

- Dr. Langley concluded: “Transdermal estrogen provides choice about expected side effect and route of administration allowing personalized treatment plans. Transdermal estradiol should be a standard-of-care ADT option in M0 disease.”

It may take some time before this option is incorporated into clinical practice.

I have been using E2 to suppress my prostate cancer and my PSA is below 0.014 ng/ml and the side effects from Orgovyx (except fatigue, muscle and libido loss) including night sweats, irritability, memory problems, have disappeared and lipids, cholesterols and glucose control are marginally improved over baseline (before starteing ADT). I am post-prostatectomy (performed Oct 2023) with no other treatments. I do have breast growth but consider it stigmata of the cancer and far preferable to osteoporosis.

Just a clinical trial of one, but supported by a large number of peer-reviewed clinical trials building a compelling argument for this treatment (which is costing me about $50 a month for the medication (not covered by insurance, so it is 100% my payment).

Thanks for reading. Good luck and God bless.

[Chadsdad]

I’ve been on Erleada and Eligard for 5 years. After RP and prostate bed radiation, an Axumin scan found 3 metastasis. 6 months after treatment started I was undetectable and a T level of <10. 4 consecutive Bone and CT scans have shown NED.

[TheLarch]

I have only been on Apalutamide for 10 months along with Lupron and Megestrol. Gleason 8, 9, 10 on all 12 cores with possible mets to rib and local lymph nodes. PSA dropped from 150 to 0.02 for the past 6 months. IMRT for 6 weeks back in April-June. So far, so good with the usual ADT side effects (brain fog, weakness, tired...).

I get blood work at least every 90 days and it's been looking pretty good.

[tayninhtom]

Yes, worked for me. Also on Lupron. Side effects: muscle cramps, hot flashes, less energy. But managable.

[PELHA]

Husband on Erleada with Lupron since March. Seems well tolerated. Numbers keep improving. Bone health supported with weights, calcium and Prolia plus low-dose estrogen patches.

[SteveTheJ]

Yes to "is earleada effective?". Your question is too vague though; can you clarify?

[docbulldog in reply to SteveTheJ]

I am totally off medication, my cancer center said I have tried everything. But it looks like erleada is still available as it is something I have not tried. There is some concern about by blood count being low specially red blood cells.

[SteveTheJ in reply to docbulldog]

My red blood cell count is normal. Calcium is normal with negligible if any bone loss. My weight is fine. The only side effect to speak of is fatigue and for that, my oncologist prescribes Provigil. I can take one or two pills/day, usually one.

But no one can tell what the side effects on you will be except you.