1. < Prostate Cancer

Question whether to add Abiraterone to treatment or not?

Posted by stew80 @stew80, May 14 9:18am

After a recent visit my Oncologist 'thought' I could add Abiraterone to my Eligard injections and upcoming radiation treatments. I have Gleason 9, Cribriform and PI but NO evidence of metastasis including lymph nodes. With the radiation and Eligard side effects I don't really want to add another drug. Abiraterone seems to have some nasty side effects posted too. Through testing I am clearly castrate sensitive right now. Any thoughts?

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lag | @lag | May 15 4:39pm

I can't tell if stew80, the original poster, has heart issues or not. My husband has and had no heart issues, and abiraterone/Zytiga keep his metastatic castrate resistant prostate cancer suppressed for three years, with no serious side effects. I mention this for the people reading this thread who don't have heart issues and may be considering abiraterone, or whose doctors have recommended it to them.

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dpfbanks | @dpfbanks | May 17 5:03pm
In reply to @northoftheborder "Thanks for the extra context. From what I've seen, the chemo is only for using Darolutamide..." + (show)
@northoftheborder

Thanks for the extra context. From what I've seen, the chemo is only for using Darolutamide with mCSPC, based on the results of the ARASENS trial, so it wouldn't apply to your mCRPC.

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This is helpful, as we will have a decision soon about which ARPI to follow 6 rounds of docetaxel + carboplatin unusual protocol. COE suggested ‘quad’ tx of ADT and that double chemo Plus Daralutamide all at once. Our local MO compromised with starting with ADT and the double chemo, followed by the ARPI when chemo is done. Both Abiraterone and Nubeqa have been suggested. I think our MOmis leaning to Abiraterone, so been reading and finding various views on which ARPI first, but no clinical studies on this quad tx and ways to sequence it. Any studies appreciated, although I have a spreadsheet full. On another forum someone said they are doing this quad protocol at MD Anderson, but I can’t find any trials or info. Anyway, thanks for this sequence thinking.

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chippydoo | @chippydoo | May 18 9:35am

How much Cribriform and in how many pins? I had 10% in one out of 12 pins.

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1 reply
jeff Marchi | @jeffmarc | May 18 10:36am
In reply to @chippydoo "How much Cribriform and in how many pins? I had 10% in one out of 12..." + (show)
@chippydoo

How much Cribriform and in how many pins? I had 10% in one out of 12 pins.

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The question with cribriform Is not how much there is it’s how large it is. If it’s over .25 mm it’s a real problem. If under that, Not such a big deal.

In this video, Dr. Epstein discusses the risk of cribriform and active surveillance, It’s at least a half an hour and if I remember correctly.

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Sicetnon3 | @sicernon3 | May 18 1:46pm
In reply to @stew80 "Thanks for responding. How are the Abi side effects for you?" + (show)
@stew80

Thanks for responding. How are the Abi side effects for you?

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In my case, hot flashes, brain fog and fatigue accompany the combination of abiraterone and Lupron. I had an ECG and Holter monitor a couple months ago and all turned out fine.

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stew80 | @stew80 | May 18 4:31pm

As a side note I see Joe Biden has joined the PC world. Gleason 9, Grade 5, met to the bone.
Someone recently said to me - "Prostate Cancer is a tax a man pays for living a long life." I know younger men have it too, but this quote resonated for me as an 80ish year old guy.

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1 reply
northoftheborder | @northoftheborder | May 18 6:34pm
In reply to @stew80 "As a side note I see Joe Biden has joined the PC world. Gleason 9, Grade..." + (show)
@stew80

As a side note I see Joe Biden has joined the PC world. Gleason 9, Grade 5, met to the bone.
Someone recently said to me - "Prostate Cancer is a tax a man pays for living a long life." I know younger men have it too, but this quote resonated for me as an 80ish year old guy.

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Yeah, sometimes we pay the tax a bit prematurely. And unfortunately, the number of men diagnosed with de-novo metastatic PCa in their 50s (and sometimes even 40s) is rising.

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Sicetnon3 | @sicernon3 | May 29 11:11am
In reply to @laccoameno5 "You are so lucky. diagnosed 3/2019 PSA 43 Gleasons 7-9 RP 5/2019 38 lymph nodes removed,..." + (show)
@laccoameno5

You are so lucky. diagnosed 3/2019 PSA 43 Gleasons 7-9 RP 5/2019 38 lymph nodes removed, 8 with PC, all nerves too. RT then ADT and the horrors of Lupron begun, 2 sessions over 2 years, quit both due to horrible SE's. PSA 0.03 then started to rise again . Now Abiraterone only. Done with Lupron. Bad SE's with this similar to Lupron. How bad? Can maybe crawl to the toilet from bed. Nausea, hot flashes, very weak, dizzy spells, dry mouth at night, almost suffocating. sore all over. Major brain fog. Impossible to get more than 1 hour of sleep. I now understand how some just give up. Suicide while rare, does happen.
Lacco

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Yes, it seems everyone is unique and have unique reactions to the various therapies. Some call it luck, others blessing. Still, I think the same “thing” is present in both. It is a mystery to me how I am what I am.

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Sicetnon3 | @sicernon3 | May 29 11:15am

Yes, it seems to be a roll of the dice in many aspects. Sometimes they come up “7”. Is it just physics or something else? Perhaps both…

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