Be aware that the PARP inhibitor is very hard on the body. When I was on Zytiga for a couple of years and my PSA would not stay down (bouncing around from .2 to .7 and back) I asked her about going on a PARP. She said no because of its effects on the white blood cells, platelets, hemoglobin and hematocrit.

I really became aware of how hard PARP inhibitors are on the body when I was paid to do a review of the documentation of the product Akeega, before it came out. It is a combination of abiraterone and a PARP inhibitor. There were constant warnings in the documentation about problems with your blood tests and all the different items in the blood that could have poor results, which would mean that the drug would have to be stopped immediately. That sure explained why my oncologist had not wanted me to go on it yet.

Many doctors are doing PSMA tests with the PSA very low or undetectable. This is because if there are metastasis that are large, they will show up anyway. I hear about it in the advanced prostate cancer user group meetings I go to weekly. Some people are getting PSMA pet test every three months. It varies a lot.

Wish you well in your vacation from drugs. I am 76 and after being on ADT for over seven years it’s no big deal. Sure I get a hot flashes a few times a day, and the Brain fog is a pain, I’ve never really had a fatigue issue, but I keep active and walk a lot, something that beats the fatigue.