Stage 4 Prostate Cancer and Hormone Therapy quit working

99% of my treatment have been at CVH Credit Valley Hospital in Mississauga On I was referred to PMH for LU 177 trial but missed it Head of oncology had CVH put me on 6 injections of Xofigio or Radium 223 which did some good Then the 2 chemo's and fluid on lung Getting blood work today Have PSA flair 30% get it PSA 721 We need it to reduce

Thanks friends News welcome

I'm sorry to hear th1at you are having a tough time.
If you look back at the sequel l , nce of receiving the lupron and the radiation, are you able to say which one of these triggered which side effect? I know it's a tall order...just wondering.
Did the side effects come on gradually?
So far, my experience has been:
1. Noticed memory changes and mood shifts shortly after the first injection.
2. Felt nauseous the night after first rad treatment
3. Going into 3rd week of rad and feeling fatigue. Changes in bowels since 1st week of rad.
What do I do?
Walk 25-30 min daily on treadmill
Try to do 10 M of weight lifting every other day.
Eat mostly plant based food with occasional poultry or fish.
I'm no longer experiencing nausea.

2.

Blood work Ok Reducing prednisone to get me off it. Lungs still have fluid Meeting resporoligist . Once tis is over may start me om Zytiga or Apalutimide

Anyone know if it works after having Xtandi and radium 22s It says it has goo OS survival ratings on Cancer Canada

Like all the -lutamides, Apalutamide can be very effective — so much so that they had to unblind the TITAN trial because it was unethical to keep half the participants on placebo. That study didn't reach median overall in its 4½ years, even (IIRC) counting those who had started on placebo and then switched and those who had become castrate-resistant during the trial, because the participants just kept living so darned long. 🙂

Erleada (Apalutamide's brand name) is in the Ontario formulary, so your ODB should cover it without having to mess with the extra paperwork around joining a patient-access programme or getting authorisation from private insurance (which is important, since it would cost nearly CA $5,000/month otherwise).

Thanks I have OHIP and private Ministry insurance I pay for Even Xtandi at 6K was covered

I am confused What about Eligard 6 as new? I think Elegard is Apalutimide

Also I thought my oncologist said Zytiga

Zytiga (abiraterone) seems similar with 3% more effective . https://www.drugs.com/compare/apalutamide-vs-zytiga

Eligard is basically Lupron. The 6 may indicate a six-month shot, as it comes in several formulations.

Erleada is Apalutamide; Eligard is Leuprorelin (an older ADT treatment that's been around since the 1980s).

Zytiga (Abiraterone acetate) is also an older treatment, from the 1990s, generally used with both ADT and a steroid.

Use those online comparisons with extreme caution (or, better, just ignore them). Our oncology teams work hard to find the right treatment for each of us in our unique cancer situations, but even if those meds were all interchangeable for everyone, 3% would be well within any margin of error anyway (I wouldn't pay attention to any difference that's not well into the double digits).

So is Apalutimide the newest and best. Zytiga has OS survival of 7 years on some men

Need OS survival stats on Apalutimide

Appreciate your comments Sounds like go with newest

Darolutamide is the newest. Has the least side effects. You’ve already been on Enzalutamide so apalutamide is almost definitely not going to help. It works the same as Enzalutamide as does Darolutamide. You need to go another direction.

If you have not been on Zytiga then it may be the best bet for the next drug, but you have to speak to your oncologist to find that out. Zytiga is hard on the heart. Can raise your blood pressure. Causes hot flashes to become more intense. Makes the brain fog worse. But it can give more years of low PSA.

Another option is BAT where you have testosterone injections to try and reset the ability of Enzalutamide to work again. Doesn’t always work.

No, definitely go with what you and your cancer team decide on after careful evaluation. Overall survival alone is a tricky stat, because we all start from different places: is your cancer localised or metastatic? castrate-sensitive or castrate-resistant? oligo or high-load metastatic? bones, lymph nodes, and/or organs? how old are you? how's your heart? how well do you tolerate hormone therapy? how active are you? do you have diabetes or other comorbidities? what have you already tried? etc etc.

If the median OS is slightly higher for one treatment than for another, that doesn't mean that the same will apply to your specific situation.