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 | Nov 20, 2022
In reply to @donaldhill9258 "Thank you Melcanada, looking forward to hearing more from you and all walking this path. As..." + (show)
@donaldhill9258

Thank you Melcanada, looking forward to hearing more from you and all walking this path. As time goes forward I will share more of my experiences as well! For now it is 8:00 on a frosty but beautiful day in Seattle😎👍 Don

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Its 89 at Sandals Emerald Bay Bahamas Back to Mississauga tonight

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spryguy | @spryguy | Nov 20, 2022
In reply to @donaldhill9258 "Thank you for your positive submissions relating to stage 4 prostate cancer. They give hope in..." + (show)
@donaldhill9258

Thank you for your positive submissions relating to stage 4 prostate cancer. They give hope in real experiences and help in navigating the dizzying array of other treatments, drugs, etc….
My journey is just beginning in Seattle. Recently diagnose with Gleason “8” and stage 4 with iliac lymph gland involvement. Bone scan next week. Starting bicalutimide this eve, bone scan in a week, and the 4 month interval (hormone?) injections a few days following bone scan. This has happened sooo quickly after a 351 psa. I am hoping this looks like a good course of treatment. 30 years ago I was referred to Mayo Clinic for evaluation of amyloidosis of skin. I was very impressed with quality of care then. So when I was browsing the Mayo website and found this support group, I jumped right in👍. Head swimming with uncertainty, and sometimes worse. Thank you all!

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I have a very similar diagnosis. In Feb 2022 I was diagnosed w G 4+3=7.
I was left in a muddle w no direction regarding R.P. surgery or radiation. I chose radiation only because I dislike anesthesia. I had no resources to guide me. I had to force the oncologist to do CT , MRI scans and PSA. He refused to do a bone scan. PSA came back at 83.4. CT showed Iliac chain Lymph Node Involvement. I received treatment with 39 sessions of IMRT and 6 mo. Lupron.
I opted to go to Mayo Phoenix ( 2 hrs drive) and saw the NEW oncologist in July 2022. I am now on a second round of Lupron and ABIRATERONE and PSA is 0.1 ng/ml and dropping like a rock. PSMA/PET/CT showed no further metastasis. My outlook is POSITIVE.
Everyone : GET A PSMA PET CT to identify further METS.

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ben789 | @ben789 | Nov 20, 2022
In reply to @ben789 "Thanks everyone for the information on here. I am going for my diagnosis on November 18th..." + (show)
@ben789

Thanks everyone for the information on here.
I am going for my diagnosis on November 18th after multiple scans and biopsy so I will be following this site.

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I got my diagnosis and luckily I don’t have any spreading from the prostate.
I will have to do radiation for 7 weeks and hormone treatments for 3 years.
I’ve got this.

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donaldhill9258 | @donaldhill9258 | Nov 25, 2022
In reply to @mtarchangel "Thanks for reaching out, Donald (Don?). I just turned 73 and like you have been pretty..." + (show)
@mtarchangel

Thanks for reaching out, Donald (Don?). I just turned 73 and like you have been pretty healthy. Never ha a broken bone or an operation or a serious illness. All in all, can’t complain even with this current challenge. Kind of “pay back” time. Our (Sherry is part of the team) first oncology appointment was just scheduled for November 29th. Feeling somewhat relieved to have it on the calendar and yet another level of anxiety over the new info/prognosis/treatment plan we might receive. I’m trying to maintain a somewhat normal routine but every pang, pain & twitch, however unrelated, gives me pause.

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Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan in a few minutes. Few symptoms or unusual pain. I have read mets is not necessarily pain dependent. Hang in there and I will too….keep the Faith, brother. Lisa wife and RN is a part of my team, thank goodness!

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3 replies
Michael in BC | @mtarchangel | Nov 25, 2022
In reply to @donaldhill9258 "Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan..." + (show)
@donaldhill9258

Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan in a few minutes. Few symptoms or unusual pain. I have read mets is not necessarily pain dependent. Hang in there and I will too….keep the Faith, brother. Lisa wife and RN is a part of my team, thank goodness!

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Strength and courage, Don. It’s great to have Lisa as part of your team. Michael

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Michael in BC | @mtarchangel | Nov 26, 2022
In reply to @donaldhill9258 "Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan..." + (show)
@donaldhill9258

Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan in a few minutes. Few symptoms or unusual pain. I have read mets is not necessarily pain dependent. Hang in there and I will too….keep the Faith, brother. Lisa wife and RN is a part of my team, thank goodness!

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How long will you have to wait for results, Don? Waiting is the worst, isn’t it? My pain pattern is highly variable. First appointment with the oncologist is coming up this week. From what I’v heard she’s one of the best. Sherry is my wife and partner and biggest ally.

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1 reply
melcanada | @melcanada | Nov 26, 2022
In reply to @donaldhill9258 "Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan..." + (show)
@donaldhill9258

Hi Michael in BC! I am sharing your stress big time😬. Going in for bone scan in a few minutes. Few symptoms or unusual pain. I have read mets is not necessarily pain dependent. Hang in there and I will too….keep the Faith, brother. Lisa wife and RN is a part of my team, thank goodness!

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Did 40 rads 5 years ago, then Zolodex fot 3 yrs. L2 nuked 1 inch out PSA was 1.2 on Zolodex for 2 years PSA up 4.22, 5.23 and now 6.6 in 4 months
Doing bone scan Monday PET nuclear than CT scan week after. Feel great Weak spine if I stand to long or walk long distance.

What you think I'm stage 4 metastatic castrate sensitive My testosterone levels are <.o4 so Zolodex works, but why PSA up to 6.6? Am I going resistive, then what?

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donaldhill9258 | @donaldhill9258 | Nov 26, 2022
In reply to @mtarchangel "How long will you have to wait for results, Don? Waiting is the worst, isn’t it?..." + (show)
@mtarchangel

How long will you have to wait for results, Don? Waiting is the worst, isn’t it? My pain pattern is highly variable. First appointment with the oncologist is coming up this week. From what I’v heard she’s one of the best. Sherry is my wife and partner and biggest ally.

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Hi Michael, scans were available to look at yesterday. No "uptakes" were positive for cancer. Though one spot on right intercostal ribcage lesion possibly... Thought I would light up like a Christmas tree! so better news and cautious optimism... will know more on Pearl Harbor Day December 7 when we meet with Oncologist. Again, fingers crossed. thanks so much for positive thought and encouragement... all of that and prayers back at you too!

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digger | @digger | Nov 26, 2022

Hi mine went to my ribs, sternum,scapula I had lupron with abitron 6 radiation treatments to prostate psa down to .04 all was good in July they found a spot on my lumbar it is aggressive prostate cancer they said i would have to have chemo had 5 rounds of chemo,after third one tested said everything looked good but I would have to stay on chemo the rest of my life or till I can’t tolerate it,this was at Cleveland Clinic came to Florida after 5th chemo treatment Dr at Moffitt is taking me off chemo getting ready to start Xofigo which is radiation injections to blood once a month for 6 months it is supposed to be easy to tolerate I would ask about Xofigo before radiation see what they say chemo was tuff but do able best thing I recommend is exercise as much as you can no matter what you do I joined planet fitness good luck Dave

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2 replies
melcanada | @melcanada | Nov 27, 2022
In reply to @digger "Hi mine went to my ribs, sternum,scapula I had lupron with abitron 6 radiation treatments to..." + (show)
@digger

Hi mine went to my ribs, sternum,scapula I had lupron with abitron 6 radiation treatments to prostate psa down to .04 all was good in July they found a spot on my lumbar it is aggressive prostate cancer they said i would have to have chemo had 5 rounds of chemo,after third one tested said everything looked good but I would have to stay on chemo the rest of my life or till I can’t tolerate it,this was at Cleveland Clinic came to Florida after 5th chemo treatment Dr at Moffitt is taking me off chemo getting ready to start Xofigo which is radiation injections to blood once a month for 6 months it is supposed to be easy to tolerate I would ask about Xofigo before radiation see what they say chemo was tuff but do able best thing I recommend is exercise as much as you can no matter what you do I joined planet fitness good luck Dave

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Was chemo oral like Enzalutamide? If not, why Enzalutamide chemo in a daily pill

Xofigo Explain how it works on bone PC metastasis .

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