Looking for advice

[WINGER19]

Okay, I just finished 6 rounds of Docetaxel. I was initially dx in Jan with advanced prostate cancer w 7 mers. PSA 11.9. Started firmagon in February and finished chemo in August. Latest PSA was 2.5. MRI shows no organ issues and an enlarged lymph node has reduced, uptake of contrast in previously noted Mets.

MO suggest continued firmagon for (though she insists Lupron, would do the same thing) and revisit everything in 6 weeks.

Urologist recommended Xgeva and insisted Firmagon is better, lower cv issues and effects 2 areas of testosterone. What would you do?

[JoelT]

You raised a number of issues.

1- The chemotherapy protocol you used is most effective for PC that is very aggressive, Gleason Grades of 9 or 10. It isn't effective for Gleason Grades that are lower. What was your Gleason Grade?

2- Firmagon is a superior drug to Lupron, but Lupron can also be effective, especially when it is combined with Casodex.

3- You mentioned that your doc said that you should re-evaluate every 6 weeks. Firmagon MUST be given every 28 days like clock work. I wold have expected to have seen a much more robust PSA response, If your Firmagon shot is every 6 weeks you are losing a significant benefit of the drug.

4- Personally, I would hoped to have seen a better response, both PSA and with your scans. Your next step should be to figure out what you didn't have a better response.

Hopefully you will see this answer before it is removed.

[WINGER19 in reply to JoelT]

JoelT thanks, I go tothe Urologist every 30 days for Firmagon, he recommending I start xgeva, my MO said to wait as I don't have osteoporosis and it's not needed yet.

[WINGER19 in reply to WINGER19]

Gleason 8

[JoelT in reply to WINGER19]

I am not a doc, but personally I would not ad have not started Xgeva without some sign of bone issues. The bone supporting drugs all come with their own side effects, some which are significant. I have been on ADT (intermittent) for 13 years and still not taking drugs like Xgeva or Zometa, but I do actively monitor my bone health and will start them when I see issues developing.

[WINGER19 in reply to JoelT]

Thank you that's exactly what my MO said, do you mind me asking if you have any bone Mets

[JoelT in reply to WINGER19]

I only have soft tissue Mets.

D- Thanks for not deleting this string

[WINGER19 in reply to JoelT]

Just left urologist, psa went up from 2.5 to 3.7

[JoelT in reply to WINGER19]

What did Urologist suggest you do?