Seems that after only 16 months of treatment this combination is no more effective. PSA is back to a little bit over 4.The last PET in November showed that the lymph nodes are not affected anymore ad shown by the previous PET from June 2023, but some more metastasis have shown on the right femur.
My oncologist does not want to change therapy. Letetium might only be available from March on. It has been approved only recently here in Italy.
My health is good, no symptoms, my blood tests are ok. What next? I'm quite uncertain about my future.
Written by
Tbo29
To view profiles and participate in discussions please or .
Have you had any chemotherapy in addition to the 2 Androgen reducer drugs? My husband (age 70) had 15 months of remission with 6 rounds of Docetaxel chemo along with Lupron injections and Nubeqa. He originally had Mets to bone and liver and has done very well post treatment, but PSA rose from .01 eventually to .33 and doctor ran bone and abdominal scans. Everything was clear except that the liver had new very small tumors. The original tumors were gone. We are going for PSMA testing to see if he is eligible for Pluvicto. If not, it’s back to another round of Docetaxel since he is not yet what they call hormone therapy resistant.
You sound very healthy and don’t have the metastasis to liver and the Docetaxel has continued to work well on my husband’s prostate and bone metastases. The liver mets are harder to treat and that’s what hopefully the Pluvicto would help him with.
Docetaxel and continuing the hormone reducer regimen might help you. It sounds like your PSA has stayed under 4 but since it is rising may need to add something. Wishing you all the best!!!
In the PRESIDE trial they found that adding docetaxel to enzalutamide can make it work longer. Without docetaxel, you wouldn't expect switching to enzalutamide to work for very long.
Ok, many thanks for the replies. I'll try to convince my Oncologist to switch from Apatulamide to enzalutamide or maybe darulutamide and will have a first round of docetaxel this month. I already bought an icecap and ice gloves and socks. Apatulamide already give me sometimes some small neuropathic problems in one of my hands. Hoping that docetaxel won't make me feel bad and that I can continue with my weightlifting and other activities. I guess there is no other choice.
I see it as difficult, in Italy it doesn't work like in the United States, they rarely use docetaxel and xtandi together, unless you are metastatic at diagnosis, in that case the triplet therapy ADT + docetaxel + darolutamide was recently approved. Anyway, you are right to try, bye, good luck.
Yeah, Italy is very bureaucratic. They are strictly following protocols and seldomly taking individual situations into account. Well, this morning my Oncologist will tell me what's in for me. I'll keep you informed.
My husband has tolerated the Darlutamide very well. He has comorbidities(heart and kidneys plus Pca metastasis to liver) so it was best choice for him, but other drugs are also effective and very good depending on what is available. My husband had very little neurological effects from the combination of Docetaxel, Daralutamide and Lupron injections. He did have on occasional tingling in one hand (that he had prior to the cancer) but a little more with the Docetaxel, but overall we continued taking lots of long walks go to beach either early or later in the day (with lots of SPF sun protection and hats)and other normal outdoor activities including going to restaurants with outdoor seating(we wore masks a lot and never caught COVID).
One caveat is the first few days after the steroid wore off(you take before, day of and after for I think 3 days) he was fatigued and we had to monitor his BP, because he had a small heart attack that left very little damage about 15 years ago.
I prepared healthy low fat meals for his post chemo with red meat, chicken and turkey meals. we also had local market with prepared and cooked meats and fresh vegetables and good pasta that I cooked. Plus the first few days after used vanilla Ensure adult nutrition supplement shakes made in a small blender with low fat frozen yogurt to boost his blood counts/just 1x per day. The blood counts stayed ok throughout the treatments.
(My cousin also had cancer at same time and had Docetaxel and carboplatin for a female Genitourinary cancer and got shots to boost her blood counts when they got too low, the carboplatin is more difficult to tolerate, but she is like you athletic and very active and worked her job from home and is now in remission and back to work full time).
My husband lost his hair, but it grew right back actually nicer than before within 3 months post chemo. He did not want to cold cap and had his hair cut very short to avoid all the falling hair in our house.
All your plans sound great! Our very, very best wishes to you!!!
Well my Oncologist decided. ADT + Docetaxel. She said that's the only choice public health can give me. No more Apatulamide, nor other treatments will be given, as I'm no longer hormon sensitive. Provecto or other similar treatments will be available only after at least 3 infusions of Docetaxel if it not works. Furthermore the waiting time for Lutetium 177 will be at least no less than 6 months or more as there will be only very few hospitals offering it. I already lost precious months after the initial biopsy for the treatment to begin, and only one PET in a year passes the national health system in Italy as most Oncologists won't take the responsibility to prescribe another one to check if the treatment works.
You still have several good options, if docetaxel fails you can try cabazitaxel. And then don't forget about zytiga, it's true you failed with erleada but after chemo you might respond for a few months to abiraterone.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
ERLEADA brain dead
Eligard failure?
Orgovyx vs. Eligard
Dizziness after eligard 
Orgovyx dosage with Erleada
