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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@dirtdancer

Hi, keep up the exercises and if you can walk 30 minutes a day. I bless you for taking care of your spouse! There are and half dozen different medicines like casodex. So options there, lupron options are tougher for your body to tolerate, so try to stay with Lupron if you can. I do want to stress this is treatment and not cure. Stay the course and stay strong. I have run into many doctors who focus very little on me and quite a bit on what treatment regime I will be on. Often they don’t know my name or my chart. This is the sadness in Drs today.

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Thanks for the advice. I am on my feet from 7 am to 11 pm. Cooking, cleaning, taking care of animals, walking dog, running errands, etc. Not much time for me. But will try and get back into an exercise routine and hopefully silver sneakers for her. Still feel great, but expect that will change after the shot.

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Hi dsingstock,
I also had uptake on the Ga68 psma/pet scan , my radiotherapist didn't suspect that it was cancerous,it is apparently quite common for there to be uptake in the ribs in scan but a lot are false positives.
In this attachment you can read about it,there are also many other articles on the web on the subject.

Shared files

s13550-020-00618-0 (s13550-020-00618-0.pdf)

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@rad62

Hi dsingstock,
I also had uptake on the Ga68 psma/pet scan , my radiotherapist didn't suspect that it was cancerous,it is apparently quite common for there to be uptake in the ribs in scan but a lot are false positives.
In this attachment you can read about it,there are also many other articles on the web on the subject.

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I must apologize to dsingstock for my meaningless post above as I was reading his posts old to new and hadn't read the more recent updated posts.
I wish you all the best with your continued treatment.

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@rad62

I must apologize to dsingstock for my meaningless post above as I was reading his posts old to new and hadn't read the more recent updated posts.
I wish you all the best with your continued treatment.

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Thank you hope ypu had a wonderful Christmas. Took a holiday from a sugar fast and had a few cookies and pie and ice-cream. . Back on the fast again. Read that sugar is just as dangerous as testosterone. Still feel great, but exhausted taking care of my other half and animals. Did a honey Ham, green bean casserole, potato augraten and cherry cobbler with ice-cream. Today back on fast. Have been experiencing some daily diarrhea and can't figure if that is from my fast routine or Casodex. Taking pediolite to keep up electrolytes. 17 degrees this morning but should warm up by week's end. Hope all is going well with you.

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Can you get radiation on those spots? After my PSMA scan, I had four pelvic lymph nodes radiated. I’m also taking Nubeqa, but a year later my PSA is undetectable. Time will tell but I’m optimistic. I’m 76 years old.

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@scullrower

Can you get radiation on those spots? After my PSMA scan, I had four pelvic lymph nodes radiated. I’m also taking Nubeqa, but a year later my PSA is undetectable. Time will tell but I’m optimistic. I’m 76 years old.

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On Zolodex yet as PSA up from 1.2 to 6 even after L2 lumbar radiated 2 years ago they want me on enzalutamide 4 pills a day chemo I had 40 x radiation in 2018 but last year it came back to spine Castrate sensitive now turning resistive

Any experience with Enza please I'm 78

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Discussed radiation with Oncologist and they said no. Reason it would not kill the cancer as it was recurred stage 4. Maybe it was not applicable to my situation. My son is an MD and he asked about radiation treatment and the response was that radiation is used to relieve pain. And since I had no pain in the lower right ribs where the cancer had metastasized it wasn't needed. Oncologist Drs settled on Eligard 6 month injection and Xtandia. Urologist wants another PSMA PET scan. Last psa taken 13 Dec 2.7. Down from 18.5 on 16 Nov. Currently on Casodex started 17 Nov. Eligard injection scheduled for 9 January and scans on the 10th.

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@dsingstock

Discussed radiation with Oncologist and they said no. Reason it would not kill the cancer as it was recurred stage 4. Maybe it was not applicable to my situation. My son is an MD and he asked about radiation treatment and the response was that radiation is used to relieve pain. And since I had no pain in the lower right ribs where the cancer had metastasized it wasn't needed. Oncologist Drs settled on Eligard 6 month injection and Xtandia. Urologist wants another PSMA PET scan. Last psa taken 13 Dec 2.7. Down from 18.5 on 16 Nov. Currently on Casodex started 17 Nov. Eligard injection scheduled for 9 January and scans on the 10th.

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My radiation specialist wants to radiate my L2 again to continue to knock out the cancer 1 inch not just for pain relief which I have little

I'm 78 with 3 month injections of Zolodex Putting me on 4 chemo pills a day of Enzalutamide. How do we differ?

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@melcanada

My radiation specialist wants to radiate my L2 again to continue to knock out the cancer 1 inch not just for pain relief which I have little

I'm 78 with 3 month injections of Zolodex Putting me on 4 chemo pills a day of Enzalutamide. How do we differ?

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I am 82 and cancer recurred a little over a year ago. Have both Urologist and Oncologist treating me. Psa had a quick rise from >0.0 to 20.8. Urologist wanted a PSMA PET scan and prostate biopsy. Scan showed possible contrast rise in lower right rips. Possible cancer metastasized but not sure. He scheduled another scan with same results and psa continued to rise. Called in Oncologist and not sure if cancer has metastasized. They scheduled CT's with IV contrast to chest and abdomen. Abdomen clear but chest showed what us believed metastasized cancer on lower right ribs 7 and 9. Oncologist wants to start hormone therapy of Cadodex for a month then Lupron (6 mos) injection. Started Casodex and shifted Cancer Centers to be closer to home. New Oncologist changed Casodex to Apalutamide daily and Eligard. Insurance would not cover Apalutamide only Xtranida (backorder). Then after 2 PSMA PET and 2 CT scans Urologist wants another PSMA PET scan. Where I stand niw is on daily Casodex, Eligard injection (6mos) injection on 9 Jan, and 3rd PSMA PET scan on 10 January. Then won't see both Urologist and Oncologist last week in January. Psa has gone from 20.8 on 9 November to 2.7 on 13 December. That is where I stand. So far feeling great with no pain. Seems that everyone I communicate with had different treatments fir advanced/recurred Cancer. Hope you are doing well.

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@dsingstock

I am 82 and cancer recurred a little over a year ago. Have both Urologist and Oncologist treating me. Psa had a quick rise from >0.0 to 20.8. Urologist wanted a PSMA PET scan and prostate biopsy. Scan showed possible contrast rise in lower right rips. Possible cancer metastasized but not sure. He scheduled another scan with same results and psa continued to rise. Called in Oncologist and not sure if cancer has metastasized. They scheduled CT's with IV contrast to chest and abdomen. Abdomen clear but chest showed what us believed metastasized cancer on lower right ribs 7 and 9. Oncologist wants to start hormone therapy of Cadodex for a month then Lupron (6 mos) injection. Started Casodex and shifted Cancer Centers to be closer to home. New Oncologist changed Casodex to Apalutamide daily and Eligard. Insurance would not cover Apalutamide only Xtranida (backorder). Then after 2 PSMA PET and 2 CT scans Urologist wants another PSMA PET scan. Where I stand niw is on daily Casodex, Eligard injection (6mos) injection on 9 Jan, and 3rd PSMA PET scan on 10 January. Then won't see both Urologist and Oncologist last week in January. Psa has gone from 20.8 on 9 November to 2.7 on 13 December. That is where I stand. So far feeling great with no pain. Seems that everyone I communicate with had different treatments fir advanced/recurred Cancer. Hope you are doing well.

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I appreciate your comments. And I appreciate reading your journey. From reading the comments in this thread, I see a wide range of pills that successfully treat cancer to contain it. All are very expensive and I am beginning to think prescribed to contain-not cure. Sadly saying this. I would keep on the path, however, as containment seems to allow us to have a good quality of life.

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