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Stage 4 Prostate Cancer and Hormone Therapy quit working
Prostate Cancer | Last Active: 2 days ago | Replies (67)Comment receiving replies
Darolutamide is the one to use. As the least side effects of all three, if you look at studies, we see that if fewer people drop Darolutamide than the other lutamides because of side effects. It has also been approved for mCSPS and mCRPC.
After 2.5 years on Zytiga I was undetectable for one month. With Darolutamide i’ve been undetectable for the last 11 months.
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Yes, that makes sense, with the caveat that if you're already on one of the -lutamides and it's been working for a while with tolerable side effects, it doesn't make sense to "roll the dice" and switch to a different one, even if the dice are loaded a bit in Daralutamide's favour as @jeffmarc reports: after all, in that case you now know with 100% certainty ex-post that your current -lutamide is working (whatever the probabilities were ex-ante, before you started taking it).
OTOH, if your current -lutamide isn't keeping your PSA low/undetectable, or if you're finding the side-effects so difficult to tolerate that you've considered stopping, then it makes sense to talk to your oncology team about trying a different med. Everyone's reaction will be different, and we're fortunate that we have so many good options these days.