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My husband has stage 4 metastatic prostate cancer
Prostate Cancer | Last Active: May 2 9:52pm | Replies (40)Comment receiving replies
I am de nova stage 4 Prostate Cancer metastatic in bones only. At diagnosis my PSA was slightly above 32 and I had severe bone pain from metastases in my spin and ribs. I did palliative radiation to my spin (10 cycles) and ribs (5 cycles), and triplet Eligard + Nubeqa + Chemo (10 cycles). After treatment my PSA has remained undetectable and my Alkaline Phosphase has remained as low as 37 indicating no cancer growth in the bone. After my initial diagnoses and bone scan, I have received 2 additional bone scans. Both showed improvement from the first bone scan.
My oncologist says I actually had quadruple therapy. Everyone experiences chemo and medications different, but I agree with one of the earlier posts. Hollywood has created in the mind of the public that chemotherapy is worse than it really is. While Castrate Sensitive, Radiation and Chemotherapy are the only treatments that actually kill cancer cells. Eligard and Nubeqa block the creation of testosterone within the body and starves or weakens the cancer cells. If you handle it, Carpet bomb the cancer up front. Do not allow any micro metastases to hang around. If you can handle it, I recommend 10 cycles of chemotherapy as it will increase Overall Survivability and kill as many micro metastases. The 6 cycles was arbitrarily selected by the medical community.
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Thanks for sharing that. That's great news!
For anyone else reading, I understand that the ALP is a bit tricky to interpret in isolation because it can rise with *any* bone distress, not just an active metastasis. Mine spiked to near the high end of normal at first, probably because of the emergency surgery on my spine to debulk the lesion (which was compressing my spinal cord), the radiation to the site, and irritation from the cement and four metal rods there now holding it together. After a year and a half my ALP came down to mid-range normal and has held there since, while my PSA has remained below 0.01 (undetectable on the ultra-sensitive test) all the way through thanks to Firmagon and Erleada (and 20 rounds of SBRT to my prostate).
So if you have low PSA and normal ALP, great! By my layperson's understanding, that means it's less likely you have any active bone metastases. But if you see the ALP rising, it could be just about anything that can irritate bones, so please don't panic (like I did, a bit), and assume it's new bone metastases. My onco team told me that as long as my PSA was that low, borderline-high ALP was extremely unlikely to be caused by new cancer activity.