1. < Prostate Cancer

Stage 4 prostate cancer treatment options

Posted by safari1949 @safari1949, Nov 17, 2019

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.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Moderator
Colleen Young, Connect Director | @colleenyoung | Mar 2, 2020
In reply to @norske46 "Does anyone have experience with enaxutimide as a treatment for stage 4 prostate cancer?" + (show)
@norske46

Does anyone have experience with enaxutimide as a treatment for stage 4 prostate cancer?

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@norske46, do you mean ethosuximide, the anticonvulsant?

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norske46 | @norske46 | Mar 2, 2020

I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from bicalutamide.

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1 reply
Moderator
Colleen Young, Connect Director | @colleenyoung | Mar 3, 2020
In reply to @norske46 "I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from..." + (show)
@norske46

I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from bicalutamide.

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Ah, yes. Enzalutamide (Xtandi®) makes more sense. Seems like not many in the group have been prescribed enzalutamide. Is this something your oncologist is recommending for you Norske?

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1 reply
norske46 | @norske46 | Mar 3, 2020
In reply to @colleenyoung "Ah, yes. Enzalutamide (Xtandi®) makes more sense. Seems like not many in the group have been..." + (show)
@colleenyoung

Ah, yes. Enzalutamide (Xtandi®) makes more sense. Seems like not many in the group have been prescribed enzalutamide. Is this something your oncologist is recommending for you Norske?

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Yes, bicalutamide didn't get the job done so I will start enzalutamide as soon as it arrives in the mail. Cancer has spread to my spine and PSA has gone back up to 46.9. We need to find something to get it in check.

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2 replies
Moderator
Colleen Young, Connect Director | @colleenyoung | Mar 3, 2020
In reply to @norske46 "Yes, bicalutamide didn't get the job done so I will start enzalutamide as soon as it..." + (show)
@norske46

Yes, bicalutamide didn't get the job done so I will start enzalutamide as soon as it arrives in the mail. Cancer has spread to my spine and PSA has gone back up to 46.9. We need to find something to get it in check.

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Oh, I see. I'm sorry to hear about it spreading to the spine. Be cautious with your activities and be kind to your back. Are you experiencing pain?

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norske46 | @norske46 | Mar 3, 2020

No, no pain at this time. I am trying to be good to myself while maintaining "normal" activities.

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stoney1967 | @stoney1967 | Mar 4, 2020
In reply to @waynen "The problem is how to treat the more advanced levels of the cancer, i.e. Gleason score..." + (show)
@waynen

The problem is how to treat the more advanced levels of the cancer, i.e. Gleason score of 8 or higher. That's when they feel that ADT becomes important. My radiation oncologist told me on my first visit that using Lupron with radiation increases my chance of "survival" by 20%. It brought it up from 60% to 80%, and I didn't have any secondary spread of the cancer. Needless to say that caught my attention. So, my wife and I are willing to live with the issues that come with Lupron.

If you want to explore other options, you could look into new treatments for people who inherit mutations in DNA-repair genes found in advanced prostate cancers. If you go to Practice Update Advanced Prostrate Cancer and look at the video expert opinion section. There's a February 25 interview on Inherited DNA Repair Defects. I don't know if you've had Genome testing, but about 12% of men with advanced prostate cancer can have these defects and can be treated without radiation or surgery. It wasn't a part of any discussion I had with any doctor.

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Mayo oncologist did amazing treatments for me .

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stoney1967 | @stoney1967 | Mar 5, 2020
In reply to @semeon "I have been on Lupron for18 months really not affected too much by weight gain. My..." + (show)
@semeon

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.

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That sounds like me

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antelope | @antelope | Apr 28, 2020
In reply to @semeon "I have been on Lupron for18 months really not affected too much by weight gain. My..." + (show)
@semeon

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.

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what joints?my knees were hurting quite a bit til I resumed my training,could tht pain be from the chemo and lupron? thanks

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rso | @rso | Jul 5, 2022

When I first was prescribed abiraterone I was able to obtain a grant which covered the cost.

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