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.

melcanada | @melcanada | Oct 16, 2022
In reply to @rso "This is just my experience so you can make your own decision, but I wish my..." + (show)
@rso

This is just my experience so you can make your own decision, but I wish my urologist had done a biopsy on me when I was being treated for what he assumed was bladder cancer. Turns out the cancer was primary prostate. I was 62 at the time. My brother had a prostatectomy at age 58 and is now 86. I on the other hand have mcrpc and have recently failed my second chemo drug. That was after bracytherapy and 18 months of Lupron. Also failed on Casodex and abiraterone. Not a candidate for Pluvitco. I recently had another prostate biopsy 5 + 5 and the cancer has spread to the left side which was clear 4 years ago. I had the biopsy in the doctor's office. Prostate cancer has ruined my life. Take early action. Good luck to you.

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Get it out or radiation

Then Zolodex

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1 reply
rso | @rso | Oct 16, 2022
In reply to @melcanada "Get it out or radiation Then Zolodex" + (show)
@melcanada

Get it out or radiation

Then Zolodex

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If only. I was never a candidate for removal as the cancer had spread so bracytherapy was promising at the time.
It's been a tough road.
Just hoping others don't wait for treatment. Get tested.

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maxvt | @maxvt | Oct 16, 2022
In reply to @bens1 "maxvt: Thanks so much for that reply. All of it was really helpful and full of..." + (show)
@bens1

maxvt: Thanks so much for that reply. All of it was really helpful and full of information. I gather the pelvic exercises are what some call Kegel? Is its purpose for greater control of urination and reduction of leaking post op? What was your surgeons name, if that's ok to ask.

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Yes, kegels are the exercise. Proper PT will have you doing kegels while you are doing many other tasks, towards strengthening your core. The Therapist may also check the Abdominus Rectus muscle (horizontal across the abdomen); this can split if you try to lift a heavy item.

Dr Laviana, at University of Texas Dell Seton Hospital in Austin was by surgeon. He was recommended by my Urologist and was highly regarded by the Radiation Oncologist with whom I spoke.

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maxvt | @maxvt | Oct 16, 2022
In reply to @bens1 "maxvt: Thanks so much for that reply. All of it was really helpful and full of..." + (show)
@bens1

maxvt: Thanks so much for that reply. All of it was really helpful and full of information. I gather the pelvic exercises are what some call Kegel? Is its purpose for greater control of urination and reduction of leaking post op? What was your surgeons name, if that's ok to ask.

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Part 2:

I did 4 weeks of PT/Kegels.

RALP on 8/23, & started with diapers for almost 3 weeks with only some “spotting.”

Skipped the Guards (Depends) and used the Shields (Depends). No spotting now but wore them for 4 weeks to be safe.

My only 2 “accidents” were due to bladder spasms, while “catheterized” 5 days after surgery, both spasms on same day.

Basically, I was fully continent within three weeks of surgery.

Without the pre-RALP PT, total incontinence could last for several months.

It’s best to strengthen those muscles before someone “messes with” the pipeline down there!

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2 replies
bens1 | @bens1 | Oct 16, 2022
In reply to @maxvt "Part 2: I did 4 weeks of PT/Kegels. RALP on 8/23, & started with diapers for..." + (show)
@maxvt

Part 2:

I did 4 weeks of PT/Kegels.

RALP on 8/23, & started with diapers for almost 3 weeks with only some “spotting.”

Skipped the Guards (Depends) and used the Shields (Depends). No spotting now but wore them for 4 weeks to be safe.

My only 2 “accidents” were due to bladder spasms, while “catheterized” 5 days after surgery, both spasms on same day.

Basically, I was fully continent within three weeks of surgery.

Without the pre-RALP PT, total incontinence could last for several months.

It’s best to strengthen those muscles before someone “messes with” the pipeline down there!

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Sounds like good advice to me. Will start working on it. Thank you.

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kujhawk1978 | @kujhawk1978 | Oct 17, 2022
In reply to @patof "Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist..." + (show)
@patof

Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist informed be that a biopsy was required in coming weeks to confirm or not prostate cancer. He did not say much more, I was stunned by the news and had no questions. After much reading on several sites including Mayo Clinic, seems to me I should be waiting another 4-6 weeks and take another PSA test. Another point of interest is that I train a lot and had done 1.5 hours of cross fit the day before and the day of the blood sample to later read that I should have had 2-4 days without physical activity before the blood sample as it affects PSA test upwards by about 50-60%. Comments anyone... and thank you.

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There is some discussion about factors which may impact the results of PSA tests, exercise is one of them. Others are hydration, sex...you nay want to discuss with your medical team repeating the test and then 24-48 hours out light exercise (I usually just walk), hydrate, no sex...

If that comes back elevated, you will want to consider a biopsy but should be ultrasound and MRI guided, not just the blind TRUS - https://www.radiologyinfo.org/en/info/prostate-biopsy

Kevin

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Jerry | @jerryegge | Oct 17, 2022
In reply to @maxvt "Part 2: I did 4 weeks of PT/Kegels. RALP on 8/23, & started with diapers for..." + (show)
@maxvt

Part 2:

I did 4 weeks of PT/Kegels.

RALP on 8/23, & started with diapers for almost 3 weeks with only some “spotting.”

Skipped the Guards (Depends) and used the Shields (Depends). No spotting now but wore them for 4 weeks to be safe.

My only 2 “accidents” were due to bladder spasms, while “catheterized” 5 days after surgery, both spasms on same day.

Basically, I was fully continent within three weeks of surgery.

Without the pre-RALP PT, total incontinence could last for several months.

It’s best to strengthen those muscles before someone “messes with” the pipeline down there!

Jump to this post

Good to hear of your fast recovery. I’ve recovered too after my RP surgery; however, my recovery experience was more typical. Despite exercise and Kegels, I went from no bladder control for about six week to gradual improvement. It took me nine months to recover and become continent again. If there are other readers who are struggling, don’t be discouraged. There is hope. Jerry

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biih | @biih | Oct 17, 2022
In reply to @patof "Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist..." + (show)
@patof

Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist informed be that a biopsy was required in coming weeks to confirm or not prostate cancer. He did not say much more, I was stunned by the news and had no questions. After much reading on several sites including Mayo Clinic, seems to me I should be waiting another 4-6 weeks and take another PSA test. Another point of interest is that I train a lot and had done 1.5 hours of cross fit the day before and the day of the blood sample to later read that I should have had 2-4 days without physical activity before the blood sample as it affects PSA test upwards by about 50-60%. Comments anyone... and thank you.

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Have you researched “ Watchful Waiting”? With a low PSA you may want to wait 3 months…I would also do a MRI first then a biopsy. But i would not rush into anything at this point…

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pamperme | @pamperme | Oct 23, 2022
In reply to @patof "Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist..." + (show)
@patof

Hi everyone. I'm 58, got a PSA result 2 days ago of 5.2 and the urologist-oncologist informed be that a biopsy was required in coming weeks to confirm or not prostate cancer. He did not say much more, I was stunned by the news and had no questions. After much reading on several sites including Mayo Clinic, seems to me I should be waiting another 4-6 weeks and take another PSA test. Another point of interest is that I train a lot and had done 1.5 hours of cross fit the day before and the day of the blood sample to later read that I should have had 2-4 days without physical activity before the blood sample as it affects PSA test upwards by about 50-60%. Comments anyone... and thank you.

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I can give you my experience. I am 69 and December 2021 had a psa of 5.34 compared to my 3.15 psa 2 years earlier. My Urologist recommended an MRI and scheduled me for a second psa. The second psa test was 5.45. The MRI showed a 2.5 cm lesion in with a high likelihood of being significant cancer. They performed a biopsy and also targeted the lesion and I had Gleason 7 3+4 cancer.

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3 replies
wizzy | @wizzy | Oct 24, 2022
In reply to @pamperme "I can give you my experience. I am 69 and December 2021 had a psa of..." + (show)
@pamperme

I can give you my experience. I am 69 and December 2021 had a psa of 5.34 compared to my 3.15 psa 2 years earlier. My Urologist recommended an MRI and scheduled me for a second psa. The second psa test was 5.45. The MRI showed a 2.5 cm lesion in with a high likelihood of being significant cancer. They performed a biopsy and also targeted the lesion and I had Gleason 7 3+4 cancer.

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What did you do like treatment

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