Treatment for Prostate Cancer Metastasized to Bones

What were the indications that you could stop taking your meds? I have been on Erleada and Zoladex for almost two years and my PSA is basically non-detectable. My Oncologist has never suggested that I stop any meds. I find the Erleada side effects very difficult to tolerate.

Rick, I have CR aggressive, locally advanced, gleason 9 PC. I had surgery 6 months after starting these meds and 6 months after, all part of a Jansen clinical trial at UCLA. For the last 10 months and maybe more, my PSA has been .01 The reason I stopped the meds is because of the clinical trial procedure and because my PSA did not rise. Hence, I was helpful to Jansen in their trial and Jansen was helpful to me. My doctor advised me that in time the PSA will rise and then they will put me back on Lupron and Erleada and perhaps more ( if it doesn’t work they will switch me to something else) 2 years ago my prognosis was 2-4 years and I am hoping and working hard to make it much more. Good Luck to you!

Russ hates it ! Hurts bad pain joints and back ! Who wants to live on pain meds it sucks 😞 not sure what he will decide ! Taking a trip to Arizona for nice weather ! God bless 😊

I'm sorry to hear that. I hate pain meds too.

I've been trying for over a year to slowly titrate off Pregabalin (Lyrica) because it increases my feelings of numbness, which are already bad enough after the spinal damage. But every time I get it down (gradually reducing over a month or two), it seems ok for a week or so and then pain roars back like an express train.

I've decided to give up the struggle for 2023, but might try again in 2024.

I had no joint pain for the 13 months on Erleada and the 10 months off of it but I now have a lot of joint pain in my right hand, can make a fist, 3 fingers can’t close, burning sensation in my palm, hard to write, hold fork and knife, etc. My left hand is now starting to stiffen up too. I would like some meds for this but I don’t want to be sleepy all day. This side effect is truly new to me and it is easy to hate.

I'm so sorry to hear about that. I also had pain and trouble closing my right fingers into a fist, about six months in. I don't know if it was the Erleada, early arthritis, or something else.

It was especially upsetting for me because I had played classical guitar before my cancer diagnosis and hospitalisation, and I didn't want to lose that on top of everything else.

I worked hand exercises into the physiotherapy I was already doing, including squeezing foam balls and then exercise grips. I still have some issues, but in my case the daily exercises eventually dealt with most of the pain and stiffness, and let me play guitar again (including at my daughter's wedding).

As always, your mileage may vary.

That is good advise, thank you. I will get some foam balls and
grips and give it a try. I was learning the guitar but the hand issue put an end to that. I was told to try learning a keyboard.

I just watched a video given by Dr. Eugen Kwan at the Mayo Clinic. He recommends a 3-pronged treatment plan. First being Eligard, then along with Doralutamide or Abiraterone and then 6 cycles of IV infusion given once every 3 weeks of Docetaxel.

I'm in Canada. The Urologist here is giving me Eligard and Apalutamide.
According to Dr. Kwan the 'Triple Therapy' is a cure.

I have to now ask my Urologist why he is only giving me the Hormone Treatment when the 'Triple Therapy' according to Dr., Kwan is the new "IT' treatment.

I guess I might have to go to the Mayo to get proper treatment.

Anyone else had this 'Triple Therapy'...Has it worked??

I forgot to add that the Prostate Cancer has metasasized into the bones

Thanks for your post. I'm in a similar situation in Canada — on Firmagon and Erleada, with bone-oligometastatic prostate cancer. My onco team is sticking with that because I'm tolerating it well and it's keeping my PSA undetectable and other bloodwork and tests in a healthy range. The team lead told me there are "lots of other things" to try if this stops working, but also that he's had patients in my situation go many years without any progression.

I don't have the expertise to evaluate the scientific papers that I have skimmed, but my impression is that the 3-pronged approach is still very experimental and based on early research — it might help or it might make you feel worse.

I don't think there's a consensus in oncology yet that metastatic prostate cancer is curable per se, although some researchers believe that oligometastatic prostate cancer might be, and I had curative (rather than palliative) doses of radiation myself.

The thing about ADT and Erleada is that there's really solid research showing its effectiveness in postponing progression (the Titan study). I, too, will be keeping an eye on other options and discussing them with my team.