Metastatic Prostate Cancer: Where do I go from here?

Posted by dsingstock @dsingstock, Sep 26, 2022

PSMA PET scan revealed radiotraser uptake in the right 7th and 9th ribs consistent with osseous metastasis. . Where do I go from here. I am 82.

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@norske46

@dsingstock : I am sorry to hear of your diagnosis. My first advice is to stay positive and be patient (I know how hard that is). Here is my story as an example. In February 2019 I was diagnosed with metastatic prostate cancer. PSA was 541. I had cancer in my spine, some on the sternum and ribs. I started on hormone therapy using bicalutimide and added Eligard a month later (I get a shot every six months). I had 44 radiation treatments that summer. PSA dropped but started to rise again so we went to Enzalutimide. We added radium223 treatments before going to docetaxel. My PSA dropped again but now has started to rise again so I just started back on Enzalutimide to see if we can bring the PSA down again.

The take away from this is there are many treatment options available to you. Talk to your care team (primary care provider, urologist and oncologist) to develop a treatment plan. Be patient and continue to do those things that give you enjoyment. I find prayer to be helpful. As scary as the initial diagnosis is, there is time for successful treatment to bring the cancer under control. I have been at it for 3.5 + years. Stay positive.

Good luck on this difficult journey.

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4 years after 40 radiation treatment C appeared in my L2 lumbar as PSA went from <.01 to 26 Intense radiation on L2 took out 1 inch C Back on Zolodex as I am Stage 4 metastatic but castrate sensitive so PSA now 1.2 but yesterday test was 4.22 Should I be concerned? Just turned 78 Feel great
Enzalutamide waved off until if and when needed
Testosterone feeds pc Forget sex If needed you have 10 fingers and a tongue to please partner

Google St Rita saint of the impossible Her intercession has aided me amazingly I am castate sensitive because of her prayers to JESUS Oncologists had written me off and wanted chemo enzalutamide 2 years ago

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@lleecc

I can’t help you but I think I’m in the same situation as you. I’m 77 and a recent bone scan revealed widespread osseous metastatic disease. Briefly,
I have very little libido and my size is pretty minimal after being on testosterone deprivation therapy for about two years. Extremely frustrating not to be as intimate as I would like with the lady I dearly love. Though she is very understanding and accommodating I know it is very difficult for her, too.

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@lleecc, to offer a woman's perspective, cuddles, touching and just being together to share experiences count as intimacy too.

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@dsingstock

Thank you for sharing this wealth of information. Sounds like you have been to hell and back and still maintain a positive attitude. That is wonderful and I compliment you for that. My last psa was 12.2 and rising about 1.5 per month. I am told it is non curable stage 4 and metastasized in lower right ribs. Also like with you it can be controlled with the right medication. This will happen in November when I have appointments with both Urologist and Medical Oncologist. You hit the nail on the head about staying positive. Prayers help too. I need to stay strong as I am the care giver for my other half with vascular dementia. Thank you so very much for your come back . That I really appreciate, especially the meds. Take care and God bless.

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Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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@plugger

Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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I am surprised ( and amazed) at the comments shared by the guys above…
My journey began in 2004-5 with PSA 6.9 and gleason 6…(Not sure the ratio). I had 8 weeks of radiation thinking the best for the future.
However, in 2021 (17 years later) MRI and biopsy showed a BCR. Even though my PSA was only 1.6, it was slowly increasing…consults with my local doctor to Memorial Sloan Kettering (NYC) recommended Salvage HD Brachytherapy…Having had radiation initially i decided against it. I am not sure about cryotherapy…From Oct. 21 to March 22, i was on firmagon (ADT) which was difficult…
I don’t know how some of you are maintaining a positive attitude…
I am waiting for a another PSA in December . It is currently - .444 after having ADT.
I hope whatever the next step i will remain positive…Thanks for sharing all of your experiences…Peace to you all…

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@plugger

Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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2017 PC with 40 days radiation Jan 2018 + Bicalutamide and 1 year Zolodex so PSA then <.01
March 2021 PSA 26 and MRI found L2 lumbar with 1 inch of cancer then intensely radiated and back on Zolodex and now every 3 months Recently PSA rose to 4.22 then 3 weeks later 5.32 I feel great but concerned I have been Stage 4 castrate sensitive metastasized Pray its not turning resistive 78 last month

Phone call with Oncologist Monday St Rita please intercede again for me

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Finally met with Urologist and Oncologist. Plan is to do 30 days of Casodex, get CT scan with contrast of my chest area to enlarge metastasized area of tye ribs and get a 6 month Lupron injection. Started Casodex but CT and Lupron injection to follow a shortly. Psa taken on 9 Nov 20.8. The one in September 12.0. Heard that I should be drinking 64 ounces of water daily with Casodex. Is this true? Also to be reevaluated every 3 months and psa taken. Any other suggestions or recommendations. Thanks and God bless for what you all are going through. Dave

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@dsingstock

Finally met with Urologist and Oncologist. Plan is to do 30 days of Casodex, get CT scan with contrast of my chest area to enlarge metastasized area of tye ribs and get a 6 month Lupron injection. Started Casodex but CT and Lupron injection to follow a shortly. Psa taken on 9 Nov 20.8. The one in September 12.0. Heard that I should be drinking 64 ounces of water daily with Casodex. Is this true? Also to be reevaluated every 3 months and psa taken. Any other suggestions or recommendations. Thanks and God bless for what you all are going through. Dave

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They nuked 1 inch out of my L2 lumbar I am castrate sensitive, so Zolodex is working to stop testosterone the fertilizer of PC My PSA 1.2 but after a year now up to 4.22 Getting bone scan and CT scan to see

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@norske46

@dsingstock : I am sorry to hear of your diagnosis. My first advice is to stay positive and be patient (I know how hard that is). Here is my story as an example. In February 2019 I was diagnosed with metastatic prostate cancer. PSA was 541. I had cancer in my spine, some on the sternum and ribs. I started on hormone therapy using bicalutimide and added Eligard a month later (I get a shot every six months). I had 44 radiation treatments that summer. PSA dropped but started to rise again so we went to Enzalutimide. We added radium223 treatments before going to docetaxel. My PSA dropped again but now has started to rise again so I just started back on Enzalutimide to see if we can bring the PSA down again.

The take away from this is there are many treatment options available to you. Talk to your care team (primary care provider, urologist and oncologist) to develop a treatment plan. Be patient and continue to do those things that give you enjoyment. I find prayer to be helpful. As scary as the initial diagnosis is, there is time for successful treatment to bring the cancer under control. I have been at it for 3.5 + years. Stay positive.

Good luck on this difficult journey.

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I have it also ribs,sternum,scapula,did hormone therapy was working great psa .04 week after blood work,had a pain in my back turned out to be a new spot of cancer on my lumbar 9th rib put me on chemo had 5 cycles just started Xofigo radiation treatment today don’t know what to expect will see digger

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@spryguy

Good luck on Wed.
Two treatments. The after effects of external beam radiation (39 days of zaps) ( completed July 8) and Zytiga (abiraterone) after 10 days ( now at 30 days) of a 2 year regime. PSA is predicted to be undetectable at next blood test (Dec).. I don't know why the two years I suspect some CYA.
It is not without side effects.
Jim

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Hi, any temporary or permanent side effects from radiation?

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@bettwils16

Hi, any temporary or permanent side effects from radiation?

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Finished 39 sessions of IMRT on July 8, 2022. The first month or two after were rough with tired, weak, many trips to bathroom for both #1 and #2. Now 5 months after it's just some irregularity with #2. #1 is improved w Tamsulosin (flomax). The PLUS is a drop in PSA from 80 to 1.2 in 3 × mos, Lupron was also in play. Currently on Zytiga and Lupron, PSA is 0.1. Good Luck Merry Christmas

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