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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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Sorry I didn't get to this sooner, but, assuming they are doing a trans rectal biopsy which I think is the most common. It can be done in office or hospital setting, my doc gave me a choice. I elected to do it in the office.
I was prescribed some heavy antibiotics to take a few days before and after. In the office they gave me another antibiotic injection. There's no polite way to say this so I won't try, they basically take a device and sort of shoe horn your anus open and work through there. They gave me a local anesthetic it wasn't all that painful, I'd call it uncomfortable, but very weird. They use a long syringe type device to take cores out of the prostate for testing, in my case 12, I've heard other numbers.
After the biopsy I didn't have much pain but the first bowel movement had some pain I wasn't expecting, that was a bit shocking. You may have some blood in your urine (I didn't) and you may see blood in your ejaculate, that I did have in varying degrees till the robotic surgery.
Best of Luck to you!
Thank you. Not much fun.My urologist said I could be put out with General anesthesia so I may choose that.
I get the "scary " part. I'm 1 year into PCa and "scary" is now background noise.
The biopsy isnt fun but is tolerable with blood in urine and semen for a couple weeks.
I started at local providers and my level of disease was under diagnosed.
Contacting Mayo was my best move (6 most into treatment). My level of PCa went from intermediate risk to aggressive, high risk. That was scary. My wife was at the consult and nearly fell off her chair.
It takes time to accept the reality of cancer. I'm happy to field any questions
Good luck on the biopsy.
Thank you, spryguy. I am hearing you and will use Mayo in Florida where I live, for a second opinion and maybe the biopsy. I understand the most accurate biopsy uses the MRI and ultrasound together to take the most accurate samples. Thanks again.Every bit of info helps me (and my wife) to process.
It's not a real pleasant experience, all I can tell you is just breath. I do hope someday this can be completed with the patient being asleep.
Once I realized to breath it helped me. Once they got to 11 I knew there was only one more to do.
I had the biopsy, via the anal canal, also, performed in my Urologist’s office. No real pain, discomfort yes, and I could converse with the Doctor during the procedure. I also had the new non-invasive test, the PSMA test, completely covered by Medicare. Perhaps your Doctor has Nitrous Oxide available; I used that during my Urolift procedure, now moot as my prostate was removed via robotically-assisted laparoscopically prostatectomy. Best of luck, and prayers, to you.
I had a transrectal biopsy about 12 years ago and they missed the cancer. After the biopsy my PSA’s continue to rise so the doc decided to do a tranperineal biopsy under anesthesia. They found it then but unfortunately too late. It had already metastasized. My advice: if you want to be sure that the biopsy tells you what do you need to know ask for a transperineal biopsy!
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1 ReactionSorry it was unpleasant for you. I was told that I would be given Propranol for my biopsy so I probably will sleep.
Thank you for the suggestion. I understand they are going to use ultrasound and go through the rectum and since I did the MRI, they evidently know exactly where the potential cancer is for the biopsy. We will see.
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1 ReactionI had to look up PSMA and it sounds as if deciding what drugs to use to help with all of this can get really complicated. By the way was your robotically assisted prostatectomy something that shortened your recovery time? Did it seem safer to you?