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Is hormone therapy necessary with radiation?
Prostate Cancer | Last Active: 1 day ago | Replies (100)Comment receiving replies
I haven't posted for awhile; my story is many posts back in this thread. In short, I have aggressive cancer that has returned after RALP in 9/25 and I am beginning treatment this week.
I started radiation therapy for my pelvic region and lymph nodes today--smooth start.
I met my medical oncologist yesterday for the first time (Dr Paller at J. Hopkins) and really liked her. She agreed to my request for the Estradiol patch (which I started today) and then we discussed Nubeqa v Zytiga (with prednisone). I ultimately decided on Zytiga because: 1) The study (NRG-GU006 / BALANCE) showing significant benefit of using a second drug in addition to ADT for patients in the Luminal B subgroup (like me), used Zytiga as the second drug; 2) She preferred to keep the Nubeqa in reserve for later recurrences (consistent with the NCCN guidelines); 3) There are mixed thoughts about which drug has worse side effects (including in this thread).
I will start these drugs tomorrow.
I still am on bicalutamide; it dropped my PSA from 0.215 to 0.133 in one week--not bad. I will stop the bical when I switch to Zytiga. I had hoped to start treatment before reaching 0.2, as that leads to better outcomes, but 0.215 is not that bad.
Thanks to all of you for your encouragement and interest.
Replies to "I haven't posted for awhile; my story is many posts back in this thread. In short,..."
@bikeman1 Good to hear from you, and thanks for the data point on Zytiga (abiraterone, which I am on, along with Orgovyx and prednisone) vs. Nubeqa. I haven't yet talked with my MO about the possible role of Nubeqa in my treatment (just 4 months into it now), but I will keep that in my back pocket.
@bikeman1
You would be hard-pressed to find a doctor better than Doctor Paller. She’s one of the best.
I was on Zytiga For 2 1/2 years, It was not good for my heart, but it gave me 2 1/2 more years before I started Darolutamide. I was also on Biclutamide For a little over a year before Zytiga, My PSA rose every month while I was on it.
Actually, everybody on ADT should be on an ARPI as well. That can delay the time it takes to become castrate resistant. Something being on ADT alone becomes problematic.
Keep A close watch on your blood pressure, Zytiga Gave me high blood pressure though it doesn’t do it for everyone.
@bikeman1 How did you get set up with Dr. Paller? That seems like someone I would like to consult with.
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@bikeman1
Thanks for the update Bikeman : ))) and the best of luck with your treatment ! May this be second and the last step that you will ever need to make 🍀✨ : ))) !