Hi all! First post here. My dad (67) was recently diagnosed with G9 stage 4 pc with an high volume of bone metastases, including in pelvis, spine and ribs, and bladder and seminal vesicles and lymph nodes involvement (four or five nodes).
Therapy: Decapeptyl (Triptorelin) every 3 months, forever. Bicalutamide for the first 28 days, then suspended.
This, apparently, is SOC in Italy.
question: why is triplet therapy not being considered in my dad’s case?
I messaged the MO about docetaxel and Darolutamide, no response. Will try again but wondering if anyone has any idea as to why this might be, in the meantime.
Thanks!
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Giuliamen
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Thank you! I'll try to do so. Next meeting will be in April 2025. My dad already received his first ADT shot, and I hope it doesn't affect the possibility of still getting triplet therapy.
That's too long to wait. Triplet only works if docetaxel is started at the same time as darolutamide or abiraterone. I hope he can talk to someone sooner.
I ‘m Gleason 4+5 have it in Lymphnodes and pelvic area , ( low volume) . I thought I was also candidate for triplet, but they at Northwestern gave me doublet Daily Aberaterone/ Prednisone , Lupron shot every 3 months along with 28 rounds of Radiation. So far so good, PSA down to 0.14 from 31. It’s hovering at that number the last two tests .
Thank you for your reply, it’s more or less the same treatment plan my dad is currently on. I will try to ask about triplet therapy nonetheless, although it’s encouraging to read it’s working for you. Wishing you the best in your journey!
"Standard of Care" is neither singular nor linear; it's roots are actually legal. SOC is a very broad range of care, inclusive of even 'uncommon' investigative and treatment methods, dictated by many factors. Especially with prostate cancer, there is a need for patients and supporters to be very strong self-advocates. It can be intimidating asking/challenging docs, but critical to do, as demonstrated with your questions. All the best!
Absolutely! Thank you for your reply. I will try to enquire further about the opportunity to get triplet therapy and hear a few second opinions. Thanks again!
Most likely his age and the fact that his cancer seems to be very advanced. Can you change to a different oncologist or get a second opinion or get an appointment for a face to face talk with his oncologist so you can ask direct questions? You have the right to advocate for your father.
Thank you for your response. I already spoke to his Mo and scheduled another appointment to speak about darolutamide. I’ll also meet a different oncologist at a different centre to get a second opinion, as you suggested, in a little over a week. I really hope that there’s still hope despite the situation.
My husband was age 68 and had a similar diagnosis in Nov 2022, with numerous bone mets. He did do triplet therapy, which is clinically proven to be very beneficial in cases like these with newly-diagnosed ("de novo"), hormone-sensitive prostate cancer with a high tumor burden. He is doing very well, and his PSA is undetectable. 67 is not considered too old! If your dad is in generally good health, there is no reason for him not to do the docetaxel chemo along with his other meds. Fight for this, it is worth it. Good luck to you all.
Thank you! He has already had one Firmagon shot in late November, and his PSA went down from 1,050.00 to 28. He is starting the first infusion of Docetaxel + darolutamide next Friday. 💪 as a daughter, I am a bit scared but really hope it goes well!
It will go well.My psa was 2500 . I got triplet Firmagon+Doce+ Nubeqa.Last (6th)injection of Docetaxel was 29.2.2024 .Started Nubeqa in january 2024.In July 2024 psa eas 0,4.In end of this month I will change Firmagon(already got 19 shots/injections) to Orgovyx. Its easier to take one pill/day .And no side effects like injection site reactions/pain and chills.
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