....Dad's psa started to rising really fast doubling time is around less then three months and reached to 1.0 from 0.7 in 20 days. Seems like abiratarone stopped working, Asked medical oncologist about switching Prednisone to dexamethasone or lowering abiratarone dose from 4 tabs to single tab with breakfast, but he has no idea about this, so please guide me is it worth to switch steroids and lowering dose of abiratarone with breakfast, and what's the exact proper way to do? What are the options for him after abiratarone? He has not taken anything other than abiratarone 1000 mg plus 5 mg Prednisone and pamorelin injection when he was diagnosed stage 4 metastatic Gleason 4+4 = 8, with several mets hree and half years ago. Right now he is in perfect shape walks 18000 steps everyday. But rising psa is a concern
URGENT NEED YOUR GUIDANCE FRIENDS SWI... - Advanced Prostate...
URGENT NEED YOUR GUIDANCE FRIENDS SWITCHING STEROIDS OR LOWERING ABIRATARONE DOSE WITH BREAKFAST
Changing the dose with breakfast isn't going to change the effectivity of the drug, it will only change the amount needed to get the same dose. More Zytiga is absorbed with food so you can reduce the number of pills to one with food. This will only reduce the number pills you need to take and not how effective the drug is.
The Dexamathasone switch is to 5mg Prednisone to .5mg Dexamethasone.
He can share this information about the SWITCH clinical trial with his doctor
pubmed.ncbi.nlm.nih.gov/301...
Okay thank you
Why would you lower the dose? Is it a money issue? That's the only reason to go for a lower dose with meals.
Here's the study about switching to dexamethasone that you can share with his oncologist:
bjui-journals.onlinelibrary...
Not the money issue but I read here on someone's post that after switching to dexamethasone the psa lowered then further lowering the abiratarone dose it lowered more.....
It has nothing to do with lowering dose with fat - that only increases absorption. But there is a phenomenon that rarely happens called "abiraterone withdrawal syndrome" where completely stopping abiraterone lowers PSA. That has only been observed in a few cases where PSA has gotten high while taking abiraterone. Be careful about what you read in a public forum - there is a lot of misinformation here.
Okay thank you Allen
What would be the proper way to switch those steroids I mean so do he need to taper or something? Or just changing it straight forward? And right now he is taking 5 mg Prednisone with abiratarone so I wonder what would be his proportional dose of dexamethasone as research papers shows switching 10 mg Prednisone to 0.5 mg dexamethasone
My umderstanding is that one can switch directly from prednisone to dexamethasone. Both inhibe ACTH and the increase in aldosterone is controlled.
You should not calculate the PSA doubling time just from two PSA values three months apart. You should wait for the next PSA value before considering any change.
First of all, don't freak out over a PSA increase of 0.3. It's going to happen. Two other things.
1. As others have stated, try and switch to Dexmethasone,
2. Don't take Zytiga with food, the proper dosage can't be absorbed.
Final note; make sure your fathers oncologist is treating his cancer not his PSA. A former member here (Dan59) had an effective 3.5 year run with Zytiga and his PSA never dropped below 3.
I was on Zytiga for just 6 months. Was switched to Olaparib after having genetic testing, and found to be BRCA2+.
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