New treatment after Erleada.

[Texasjack1957]

One year on Erleada and PSA is rising. I had an Orchiectomy in Aug of '23 to shut down the tetestorone. I have extensive mets in my backbone. Looking options besides chemotherapy for the next phase in this battle.

[LuvLapsang]

Hi Jack, I’m sorry to hear Erleada failed so quickly. I was lucky enough to get a little more than two years with it, and my doctors all agreed Docetaxel was the right next step. However, if you only have bone mets, I was always curious about Radium-223. Some practices swear by it. My radiation oncologist was neutral, but my primary oncologist and a specialist I saw in one of the nation’s best hospitals both pushed the chemo because it was a required treatment prior to Pluvicto approval. I’m seeing that specialist again next week, as my PSA is rising again following my Docetaxel regimen that ended in October’24, and I’m expecting Pluvicto will be the next recommendation.

[Texasjack1957 in reply to LuvLapsang]

Thanks. So how long did the Docetaxel treatments last before your PSA started to increase? What is your PSA now?

[LuvLapsang in reply to Texasjack1957]

I ended chemo at the beginning of October, and my first PSA was 0.24. A month later it was 0.13. Then mid-December it was 0.45, then 3.06 mid-January, and 13.90 mid-February. That’s the highest it’s been in 3 years, but the PET I had at the beginning of February showed only a slight progression of disease since my PET in April 2024. I kicked and screamed to not do chemo. My experience was about as favorable as it could have been; no vomiting or diarrhea, but as MC pointed out below, the negative side effects I did have were cumulative and signaled to me that 7 doses was all I could take (my specialist wanted 10, and after 4, I thought I’d get there). It took my body 60+ days to fully bounce back. Here’s the thing… if you don’t have a favorable outcome, you can stop. Getting at least one dose meets the qualification for Pluvicto, which it sounds like many men on this board have tolerated well and have had favorable results. I’ll follow up after my appointment on Thursday to report what my specialist is recommending.

[Texasjack1957 in reply to LuvLapsang]

Thanks for your reply. When I started to treat this affliction, my PSA was at 1407. It's a hard battle.

[MelodyCat]

Sorry to hear that. It seems that switching the blocker to another works for some men. I dislike the prospect of chemo as much as you do but the side effects often are only bad near the end and there is benefits to the early treatments.

[Texasjack1957 in reply to MelodyCat]

Thank you.

[God_Loves_Me]

Trying to answer : Looking options besides chemotherapy

Ask for clinical trial recommendations and share clinical trial informations here. May be you find someone who is on that treatment and learn from it.

[Texasjack1957 in reply to God_Loves_Me]

Thanks.