← Return to Prognosis for Stage 4 Metastatic Prostate Cancer

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@wooldridgec

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.

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Replies to "Yes. I have had that treatment (triplet therapy). I have high volume de novo stage 4..."

Very similar path I have mets in bones only so they skipped chemo and I qualified for Radium 223 or Xofigio Google that Also get Xgeva injection 12 weeks and Zolodex Take 600 gms of calcium daily a mist to replace bone where cancer only is killed by Radium 223
Lu 177 is similar injection but for cancer more that just bone It may become standard of care over chemo
BTW was on Xtandi or Enzalutamide for a year but PSA went to 9.8

pray 80 and doing fine since 2017 radiation of prostate