PSA now at 15 time to start a treatment but don’t know which drugs.

[KocoPr]

It is time to beat the beast once and for all.

I had RP and EBRT 2015 now PSA is climbing pretty quickly.

PSA Trend

05/17/2022: 15.2

04/14/2022:13.45

03/09/2022: 13.3

02/09/2022: 10.3

01/12/2022: 8.4

12/01/2021: 8.93

09/15/2021: 3.6

07/21/2021: 3.08

06/21/2021: 2.4

03/23/2021: 1.8

02/25/2021: 1.9

01/28/2021: 1.3

The reason i took so long to go on ADT is I tried alternative therapies like keto, HBOT, joe Tippens protocol, and Care Oncology Protocol. They don’t work as a mono therapy. At least for my cancer.

I also tried to get on two trials but didn’t qualify.

Presently M1a CSPC.

Mets to lymphs 3 locations in pelvic, one in chest and one in clavicle. Per latest PMSA scan in Nov 2021.

Im leaning towards the ADT (Orgovyx) Nuqueba, and docetaxel. Per the ARASENS trial.

My main concern is becoming resistant thus this regimen.

Other concerns are I don’t want to stay on ADT for years, and I would like to leave open option for BAT in the future.

Am i being to optimistic?

Can I even get this treatment per FDA?

How many docetaxel cycles and is there such a thing as low dose docetaxel?

Dr Saylor at MGH says time to start lupron

Consult at Dana Faber says lupron + abiraterone/prednisone

Dr Laccetti at MSK ADT+Abiraterone/prednisone

Thank you for your expert opinions

[Hidden]

I would go with what your MO recommends. I would add a low-dose estrogen patch to ADT (if recommended) and possibly as time goes on a SARM.

COC seems reasonable to me. But the meat of their program is statins and metformin and those might help but aren't a cure.

I definitely do not want to tell YOU what to do. But I can tell you what I would do. I would focus on getting my PSA down to 1 or 2. Then I would think about doing BAT. I would research it thoroughly and decide if it made sense for me at that time.

I wouldn't mess around with getting an MO to authorize it. Because I can devote full-time care to one patient (me) I am 99.9% certain that I can do better than an MO for this particular therapy. My experience with MOs and urologists is that I understand hormones far better than most of them.

[KocoPr in reply to Hidden]

Thank you Russ so much for you help and am reading that book you wrote right now.

[Tall_Allen]

You are not newly diagnosed, so you do not meet the criteria for the ARASENS or PEACE1 protocols. That doesn't mean it won't work, it just means it hasn't been tested. ADT+ Zytiga or ADT+docetaxel may be beneficial.

Docetaxel is normally 6 cycles, 3 weeks apart - 75mg/m2 is the standard dose - lesser doses don 't work as well.

In general, earlier use of medicines delays castration-resistance for longer.

[KocoPr in reply to Tall_Allen]

Thank you TA, your a wealth of knowledge that I appreciate

[Vynbal]

You may have difficulty getting Orgovyx as your ADT. I know other guys with Adv PCa that were told that since there have not yet been any clinical trials of Orgovyx w Abiraterone that they would have to use Lupron.

[KocoPr]

Is it because FDA or Insurance? Wondering if i can buy it from Canada as long as i have a prescription

[bhayes84]

You might want to look into Artemisinin. It brought my PSA down from 9 to 2 over a 6 month period. It requires intermittent use - 5 days on, 9 days off.

[KocoPr in reply to bhayes84]

I don’t have the time to try that now as i wasted enough time trying other alternatives and failed to get into two trials.