Stage 4 Prostate Cancer and Hormone Therapy quit working

Posted by cal77 @cal77, Oct 28 12:48pm

My husband is at Stage 4 for one and a half years now...The hormone therapy (Apalutamide and Erleada) seems to have quit working. For the past 8 months, his PSA keeps climbing. It's up to 12 now..
We're scared. Anyone else got to this point? How are you doing when the hormone therapy isn't working anymore.

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@hbp

Northoftheborder. You mentioned that the Erleada titan trial did not “reach medium overall in 4.5 years”I am in that trial at UCLA and I am coming up on my 40th month. I don’t understand what you mean by “reached medium overall”. Could you please explain that phrase to me.

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I meant "median overall survival" — apologies for dropping a word.

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@melcanada

Why do you need Orgovyx with Apalutimide ? Oh I see its like Zolodex to reduce testosterones Zolodex is 1/3 the price of O

I see it works very fast Is it really that better than Zolodex I get my 3 moth injection Tomorrow at home from a RN of Zolodex

I got PSA flair up with chemo PSA shot 49 to 700 from 41 Google 40% on chemo can get get PSA flair I hear its serious if it does not go down

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I started on Firmagon (Degarelix) in 2021 because I was in a precarious situation after my PCa spread rapidly to my spine and paralysed me, and we needed to bring my testosterone down as fast as possible with no initial testosterone flare and minimal extra meds (I was already on a witches brew of steroids, blood thinners, insulin, etc trying to bring down the swelling in my spine, control DVT in my legs, and manage the steroid-induced diabetes).

Firmagon+Erleada (Apalutamide) have been working remarkably well to keep my mCSPC in full remission, but the immediate side effects from each monthly Firmagon shot were tough.

Orgovyxv (Relugolix) is a GnRH receptor antagonist just like Firmagon, but in daily pill form, and costs the same (about CA $325/month, though I haven't had to pay), so I wasn't nervous that I was taking a risk by switching.

Orgovyx seems to have become the standard ADT in the U.S. In Canada, it's still very new (Pfizer just got Health Canada approval less than a year ago), but they've priced it the same as Firmagon, and have a patient-access. programme to cover the cost until it gets added to the provincial formularies.

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@lag

Zytiga kept my husband's Stage 4 cancer suppressed for three years. It varies a lot between men--some don't respond to it at all, and the average according to our medical oncologist is 18 months, while others get a longer remission.

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Is he still with us and what is he on now?

Was something better than Zytiga if you did it again?

Was C mets only in bones like mine or had it spread outside the bones to where?

I start something in Dec after Chemo gave me fluid on lungs so have to stop it

80 feel great Had prostae radiated out 2017 Then L1 radiated 2020 Then Xtandi, then Radium 223 and 2 chemo's

Must take Xgeva to push 600mg calcium back into bone pot holes caused by killing C with chemo

Chemo also gave me PSA flair from 40 to 7000 google PSA flair 30% get it

Also get Zolodex shots to lower testosterones FYI

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@northoftheborder

I started on Firmagon (Degarelix) in 2021 because I was in a precarious situation after my PCa spread rapidly to my spine and paralysed me, and we needed to bring my testosterone down as fast as possible with no initial testosterone flare and minimal extra meds (I was already on a witches brew of steroids, blood thinners, insulin, etc trying to bring down the swelling in my spine, control DVT in my legs, and manage the steroid-induced diabetes).

Firmagon+Erleada (Apalutamide) have been working remarkably well to keep my mCSPC in full remission, but the immediate side effects from each monthly Firmagon shot were tough.

Orgovyxv (Relugolix) is a GnRH receptor antagonist just like Firmagon, but in daily pill form, and costs the same (about CA $325/month, though I haven't had to pay), so I wasn't nervous that I was taking a risk by switching.

Orgovyx seems to have become the standard ADT in the U.S. In Canada, it's still very new (Pfizer just got Health Canada approval less than a year ago), but they've priced it the same as Firmagon, and have a patient-access. programme to cover the cost until it gets added to the provincial formularies.

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Thanks I get my Zolodex shot 10 AM today in house by Zolodex people I will ask Q

See respologist this afternoon Breathing still tight 80 MG prednisone slowly being reduced
Feel good Lots of scans in December CTPET and bone.
I feel great yet cant walk far as breathing difficult caused by fluid on lung brought on by second chemo No more chemo
Also have now small embolism clot on lower lung

May start Zytiga or apalutimide late December

Keep C controlled in T 5 L2 and L5

Zytiga? Is it best for OS survival versus others? May have asked before NEED best one if doing

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@northoftheborder

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.

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Bone only T 5 L2 some L6 near tail Nothing outside bone

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@melcanada

Is he still with us and what is he on now?

Was something better than Zytiga if you did it again?

Was C mets only in bones like mine or had it spread outside the bones to where?

I start something in Dec after Chemo gave me fluid on lungs so have to stop it

80 feel great Had prostae radiated out 2017 Then L1 radiated 2020 Then Xtandi, then Radium 223 and 2 chemo's

Must take Xgeva to push 600mg calcium back into bone pot holes caused by killing C with chemo

Chemo also gave me PSA flair from 40 to 7000 google PSA flair 30% get it

Also get Zolodex shots to lower testosterones FYI

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My husband is still with us. His mets have been on his spine and other bony areas. He finished Pluvicto in August, and September scans and labs showed it was only moderately successful; his PSA indicates cancer is still hiding somewhere. He will have a PSMA PET, an abdominal and pelvic MRI, and labs in early January at Mayo Rochester and also meet with Dr. Kwon. Next steps depend on what the January tests reveal.

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@lag

My husband is still with us. His mets have been on his spine and other bony areas. He finished Pluvicto in August, and September scans and labs showed it was only moderately successful; his PSA indicates cancer is still hiding somewhere. He will have a PSMA PET, an abdominal and pelvic MRI, and labs in early January at Mayo Rochester and also meet with Dr. Kwon. Next steps depend on what the January tests reveal.

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Doing all those scans In Dec here at CVH in Mississauga Credit Valley Hospital oncology

3 KM from my home across the stream we live on Luck me NO Praise God

My oncologist Is Dr Charles Lim wow

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