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How long does your oncologist have you on ADT?
Prostate Cancer | Last Active: Sep 28 12:11pm | Replies (69)Comment receiving replies
I did not say every cell is castrate resistant. For many men who started their metastatic cancer treatment 6, 7, or even 8 years ago. The treatments was different. The medical community would start you on Casodex for 30 days and then start you on ADT. At some point resistance would set in and they would offer chemo. PSA would go down and then start to rise. Then they would start you on an ARSI like Xtandi and the ARSI would keep the cancer under control for many years - hopefully.
Now - triplet therapy has replaced doublet for high volume metastatic prostate cancer. You get all the treatments up front and they are hoping for longer deep remission.
I was told by my doctor if I ever started to become resistant they would not stop ADT or Darolutamide. I believe Darolutamide is a miracle drug and is superior to the other ARSI's.
Replies to "I did not say every cell is castrate resistant. For many men who started their metastatic..."
Casodex is only required for two weeks before Lupron (etc.). Of course, if you start with Orgovyx you can skip Casodex.
They do not offer chemo if somebody is just castrate resistant. I have never been offered chemo because it is generally inappropriate if you don’t have metastasis. I have had PC for 15 years and castrate resistant for 6. My one spinal metastasis was zapped with SBRT, appeared 2 years ago.
I’ve heard from many people that have had triplet therapy and in almost every case it’s because they had multiple metastases found upon diagnosis or after a drug holiday. In cases where there are n five or fewer metastasis, they usually like to use SBRT rather than chemo right away.
When somebody becomes castrate resistant, they are almost always given an ARSI, NCCN calls for it.. Those include Zytiga, apalutamide, Enzalutamide, and Darolutamide.
I like Darolutamide a lot, It has worked quite well for me And many other people, I know.
Apalutamide has worked quite well for some people and is now involved in a study where people who are castrate sensitive stay on it, and it prevents them from becoming castrate resistant. It’s a study so no final results are available yet. Maybe Darolutamide works the same!
You said
‘I did not say every cell is castrate resistant.”
If you review what I said, you will see I said “ not every cell is castrate resistant as you mentioned.”
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❝I believe Darolutamide is a miracle drug❞
Yes, all of the -lutamides are pretty amazing and work similarly, with small differences in possible side-effects.
That's not to say older treatments like Abiraterone can't also be effective, but studies like TITAN (Apalutamide) and ARASENS (Darolutamide) and ARCHES (Enzalutamide) have shown stunning improvements from starting an ARSI at the same time as ADT for metastatic castrate-sensitive prostate cancer, instead of waiting for castrate-resistance to set in. And as a bonus, the -lutamides don't require you to take a steroid with them like Abireraterone does.
Unfortunately, sometimes Abireraterone is all private insurance will pay for. 😕