Prostate cancer treatment choices

So, your choices are many and bewildering...

I was diagnosed in Jan 14, surgery in March, pathology report T2CNoMx, GS8, margins negative, no ECE...18 months later, BCR when PSA showed up at .2 then .3.

Did SRT, 39 treatments, 70.2 GyA...90 days after that radiologist looked at me and said PSA was .7, SRT had failed! Clearly my PCa has progressed to the pelvic lymph nodes.

I vowed to find it before making my next treatment decision! Meanwhile, PSA took off, doubling time and velocity were less than three months! Went to Mayo in Jan 17 for C11 Choline scan and consult with Dr. Kwon. We found it, four lymph nodes! Armed with that and my clinical indicators- PSADT, PSAV, GS8, BCR only 18 months after surgery I decided to be aggressive and elected to combine therapies - six cycles of chemotherapy, 18 months of ADT and 25 more radiation treatments. My radiologist, armed with the imaging from the C11 Choline scan was able to design a much better treatment plan.

The response has been great, PSA dropped to undetectable in six months and has stayed there. I have my last Lupron shot coming up on 4 May then we’ll monitor. I won’t say the last 15 months was fun but I did continue to exercise, work and travel, just completed the Memorial Bataan Death March, 26 .2 miles in the high desert at White Sands, NM.

So, my advice, do your homework, you are your best advocate, consider having newer PET/CT imaging to locate recurrence and inform your decision making. You have lot of options but keep in mind, aggressive PCa requires aggressive treatment decisions, that was one of my lessons learned.

Kevin

I have been using my Urologist only and he sent me to an Oncologist whom I met with yesterday. My PSA which had been as high as 350 and then nearly 0, after Lupron began to rise again. It is now 32. She has decided that the cancer is probably not responding to the Lupron (I've had 2 shots and am scheduled for another in August.) I am taking Trospium Chloride, Bicalutamide as well as the doxazosin Oxybutynin. She says the next step is Zytiga, which is evidently as costly as $12,000, along with Prednisone. I will take this as well as the others including Lupron. I wondered why I was sent to the financial counsellor which is understandable when you consider the cost of the drug. The next step if this doesn't work is chemo.
My cancer is evidently castration-resistant.
Any one have a similar situation and have done the Zytiga/prednisone regimen?

Has any one tried Zytiga and prednisone?
My doc is recommending this (possibly $12,000 a month. Others tell me there are others which do the same thing but are older and cheaper

Currently I am trying to decide the next step. My oncologist recommends Zyega and then Xtandi. Both are expensive but Zytiga I guess is the preferred next step. It would cost be (through my Health Plan about $3,000 a month. Xtandi, I understand,is a little less expensive but has some dramatic side effects. I had radiation several years ago and now he cancer has metastasized . I am still taking bicalutamide and 6-month Lupron shots.
Seems like everything is not working.

I hear your discouragement. This is an up and down process and I have just had some "down time" but my recent tests are good (breast and ovarian cancer) and now I want to help others cope. I hope you have faith in your oncologist but if you waver,seek reassurance here and wherever you can. There are a lot of points of view on all of this. Trust yourself.

For anyone in the Rochester, MN area, I want to let you know about a free patient education symposium: Living well with prostate cancer

Wednesday, September 5
1:45-5:45 p.m.
Greffen Auditorium
Subway level of the Gonda Building
Mayo Clinic, Rochester, MN

See details here: https://www.facebook.com/events/223582924980953/

I went thru radiation 12 years ago and now in last 2 years psa went from 0.5 to 4.3. I was told now to go with cryotherapy treatment. Has anyone gone thru this treatment and how long did it last, Thanks, Jack

Hi @hughj37, welcome to the group. I'm tagging @airjohn who had cryotherapy to treat prostate cancer. Not sure if he is still getting messages from this forum, but it's worth a try.
In the meantime, here's some information about cryotherapy from Mayo Clinic https://www.mayoclinic.org/tests-procedures/cryotherapy-for-prostate-cancer/about/pac-20384740

Hugh, when are you scheduled to get cryotherapy?

I am waiting on my last psa report and then will have to make the decison. The problem is I will have to drive to another city to get it done. I am almost 82 and not sure if I want to go thru with it

New to this site and appreciate what everyone has been through. Now my situation does not seem that bad. 2012 during annual visit to urologist, he felt nodule, PSA was 1.67. Biopsy 7 ,successful surgery by Dr Andriole, Wash U, St Louis. April 2017 PSA .04. Now .19. Urologist recommending radiation. Age 72 and heard horror stories about side affects of radiation. Anybody with similar situation, and how did you handle it?