URGENT I am on Zolodex every 12 weeks to reduce testosterone the fertilizer of pc
When cancer went to bones they radiated 1 inch out of L2 lumbar in 2020 Then put me on Xtandi or Enzalutamide which lasted a year keeping my PSA down to 1.7 It rose to 9.8 so takenOFF of Xtandi which fails after a year
They were going to start Chemo docetaxel when I went to PMH Princess Margaret Hospital and said NO
As its only in bones you qualify for Radium 223 or Xofigio which targets only cancer cells in bones and kills them and only the cancer cells No hair loss just a tad tired and occasional pooping One 3 minute injection in vein every 4 weeks for 6 months then another bone scan My local Mississauga hospital does it every Wed for me so no travel to Toronto Its all covered by healthcare I am 79 Had prostate radiated out in 2017 It came back 4 yrs later
They also include a 12 week needle injection of Xgeva that puts calcium from the blood back into the bones I take 600 mg of calcium with D and K pills from pharmacy as well as 2 apple cider vinegar gummies daily
GOOGLE all these names
Stop chemo get immediately on Xofigio. Lu 177 is still clinical trials but its for cancer that has spread outside the bones Radium 223 is for bone only which you have
Find Xofigio support from a oncologist Save yourself I am on 4th injection Feel great.

c

FIND Xofigio or Radium 223 It will save you and stop the stress Mel

oldfords, my husband is similar to your scenario; diagnosed October 2023 and had to have emergency Lymph Node biopsy because he was so ill. Unfortunately he was positive for metastatic disease in his peritoneal nodes and also soon after in his bones. No prostatectomy. His psa was at 717 at time of the biopsy. He has not been informed of either low or high in the bones, only words used in PSMA Petscan report was "scattered in skeleton" with a few suv values between 2.00-3.00. Was never given a gleason score and we only were told 2 places that had an SUV value and have no idea where else the cancer was seen. Unfortunately it was a regular radiologist that did the PSMA Petscan and not a specialized radiologist oncologist. I have spend many many hours researching and following videos, conferences, blogs, etc to learn whatever we can learn. My husband has "Aphasia" from stroke from 12 years ago so he has difficulty with language and expression. He currently on Xtandi 80mg 2x for 4 months now and as of mid March PSA down to 0.04. Very fatigued but no pain with very sore breast. We have concerns of the toxicity of Xtandi and he has CKD stage IV (also heart issues). Oncologist has not provided any other plans at this time as his words to my husband "not curable but treatable and quality of life is important" . My husband did get one injection of Xgeva but unfortunately his calcium went way down to 7.2 and oncologist nurse told us to speak to Neuphrologist about advise so we jumped on the wagon and added Calcitrate Petites (500 iu Vit D, 400mg Calcium and increased prescribed Calcitriol 0.50mcg) and stopped the Xgeva injections. Oldfords, we totally understadd getting advise from others and also would like feedback. Thinking about adding Docetaxel but our impression is that his oncologist is following the prior years recommendations and just taking an observation stance until the next stage (his oncologist calls his MCSPC and next stage would be MCRPC) but we are not comfortable with waiting and staying on the Xtandi until his cancer gets worst. My understanding is that the new recommendations are to take an earlier aggressive approach in 2024. I had read that Darolutamide is less toxic on the kidneys and the heart. Should we do Docetaxel and localized radiation or just one treatment at a time? Hope we can both get feedback.

I am now 71 years old and had this "triplet" therapy last year at Johns Hopkins. I had metastatic prostate cancer to a single vertebral body and a lymph node in my pelvis on PSMA PET. In all likelihood it had spread elsewhere but was too small to see. After the second Chemo treatment my PSA became undetectable and has remained so for more than a year.
The chemo caused some hair loss but it came back after a half year. I have had the usual side effects from the Lupron-fatigue, hot flashes, some muscle loss etc but it is manageable.
I am not sure you would get any different treatment if you lived in Boston or New York. It woulds like you are getting pretty much state-of-the-art treatment from the little you have stated.
Good luck to you and God Bless.

Yes. I have had that treatment (triplet therapy). I have high volume de novo stage 4 metastatic Prostate Cancer (PC) with metastases in the spin, hips, and ribs (i.e, bone only). I started with 10 radiation treatments to my spin followed by 5 to the ribs. Oncologist first started me on Casodex for 30 days and then I started 3 month injections of Eligard along with 600 mg daily of Darolutamide (Nubeqa). I immediately started chemotherapy (docetaxel) 10 cycles. My PSA dropped from 32 down to 1.005 at the start of chemo and then slowly dropped to undetectable (i.e., < 0.100) 2 months after chemo ended. I continue to stay undetectable. If you have PC in the bone, Alkaline Phosphatase is another important biomarker. Mine was around 180 when I was diagnosed. I consistently stay down between 38-40 now. Alkaline Phosphatase is raised when the PC destroys the bone. It is up to you, but I would request additional cycles of chemo beyond 6. The 6 cycles was arbitrarily chosen to reduce side effects. Your Overall survival goes up dramatically when you increase upfront chemo to 8 or 10 cycles. You need to ice your head, hands, and feet during chemo to reduce neuropathy. Triple therapy is the standard of treatment now and based on the results from ARSENS trial. The trial was 4.2 years and those men who got Darolutamide (Nubeqa), ADT, and 6 chemo's are still alive and are still Castrate Sensitive. Matter of fact, new ARSENS data has been recently been released, and at now 5.5 years, the results for these men are the same. Note that everyone responds differently to treatment. If you can handle more chemo, talk to your doctors about continuing if you have the resolve. Also be aware that it may take longer to recover from chemo if you do extended cycles. Darolutamide does not break the blood Brain barrier so you will not experience much brain fog. But you will get chemo brain. It will pass over time. Lastly, ask your doctor for genetic and genomic testing to make sure you do not have any genetic markers such as BRAC1 or BRAC2. If you have pain from bone metastases ask for palliative radiation to shrink to tumors. No matter what any one says, radiation kills the cancer - even palliative radiation. The idea is to kill the cancer up front and any micro metastases left behind. Think of triplet therapy as carpet bombing the cancer. Let no cancer be left behind and bite you in the butt years later. Do not give it a chance. God Bless you.