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Stage 4 prostate cancer treatment options
I have recurring prostate cancer and it has found its way to 5 different bones, including my left shoulder and two ribs on my right side. I started 6 month Lupron shots but have been told that because it is stage 4 I need additional treatment. My oncologist is recommending either Abiraterone (Zytiga) for 33 months or 6 treatments of Docetaxel chemo. She says that they look to have very equal success. With the Zytiga I will also have to take steroids, probably prednisone which I understand includes possible liver damage. Six chemo treatments seems like a better approach but I have heard Zytiiga talked about in a very positive manner. I understand it can be expensive and I do worry my prescription drug coverage could change its formulary and raise my cost significantly as well. I've already had that happen with a drug I take for Parkinsons.. Just looking for some general input regarding peoples actual experience either way.
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Hello Safari, I am also stage 4 prostate cancer to four places; Lumbar 1, Thoracic 11, Left scapula, and Right pelvic area. I have been on Abiraterone/ Zytiga since August. I have my blood checked every 2 weeks to make sure my liver is not in danger. So far, my enzymes are holding at acceptable levels.
My PSA number came down from 56 to less than 1. My understanding is that somewhere between six months, and two years the metastatic cells will eventually build up an immunity to the Zytiga. I will eventually discuss other options with my Oncologist. Best regards, Philnob.
I have had a similar experience with prostatectomy and then external radiation in 2009 right after I turned 60. My psa staid down for almost 9 years and started going up. It was 2.88 then 6 months later 6.22. Because it doubled in 6 months they had me start Lupron about 3 weeks ago and since the cancer has spread I started the Zytiga with Prednisone 5 mg daily this morning. Not sure what to expect. We were shocked that the cancer had metastasized so much with no symptoms and a low psa. My monthly cost is about $37 for both meds. My urologist and oncologist agreed that the best course for longer term is to take the treatment now rather than wait for my psa to rise again. However I won't really establish a base line until next week when they want more blood work. They will be doing a bone density test soon as a base line. Hang in there and enjoy the holidays.
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1 ReactionHello, I was wondering if anyone had experienced any weight gain on Lupron. If so, are you able to control it by dieting.
Looking forward to hearing from you. Philnob.
@philnob I am wondering the same about weight gain. I started Lupron a couple weeks ago. Within a week noticed weight increase of 3-4 pounds. Now watching diet and exercise carefully, but wondering what to expect.
I have been on Lupron for18 months really not affected too much by weight gain. My issues have been fatigue, hot sweats then cold, and sore joints.
@semeon Thank you. Your experience is helpful and encouraging.
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1 ReactionI haven’t been on Lupron for quite some time, but the weight gain continues to be a problem. I was able to lose 7 lbs. while dieting, but the weight gain around the waist doesn’t change. I plan to increase my exercise routine to see if it will help.
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1 ReactionI started abiraterone / Zytiga in August, and so far I am having good results. My PSA number is 0.84 my side effects are muscle and joint stiffness. I have my liver enzymes checked every 2 weeks, so far they are within acceptable limits. I hope this helps.
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2 ReactionsI have been receiving Lupron injections every 6 months for the last two years and have tolerated it well. See my post from Nov 22, My PSA has stayed at less than one but not zero during this time. PSA was not all that high before starting, about 8, but it had doubled over the span of about a year. I believe exercise needs to be incorporated into your activities, It will help you in a variety of ways. Both safari1949 and healer74 seem to have the right regimen. My activities not as aggressive as safari but I include light weights, stretching and treadmill. Not all of this every day but some form of those just about every day, any where from 5 to 90 minutes. Practice reasonable eating habits, a visit with a nutritionist is an excellent idea to help you define what is reasonable. Be aware that Lupron, as i've been told, can deplete calcium levels, take your calcium pills. My doctor asks me every visit if I'm taking calcium. You might also ask your oncologist if you should be taking Alendronate, ( for bone health) I started this about 5 months ago on his advice. I wasn't excited about taking it but he seemed pretty adamant. No problem with weight which I owe to the exercise and eating habits. Zytiga may be in the future but all seems to be going well for now. For safari can you tell us how you are able to keep the med bills for Zytiga and Predesone so low? Are these both generics? Appreciate this blog and all this information you are willing to share.
Hello, this in philnob. I am happy to hear that you are doing well with Lupron. I was not that fortunate, and had to switch to Zytiga, and prednisone.
My PSA number is 0.84. Every 2weeks I have blood work done to make sure my liver enzymes are normal. Due to the joint stiffness It takes an effort to motivate myself to exercise, so I start with Yoga, and work my way up to a stationary bike, and stair climber. I wish you continued success with your treatment.