Abiraterone alone for HT ADT therapy for PC

Glad to hear hear you’re cancer is now undetectable!
I had cancer too in a lymph node. I’ve had my PSA tested every three months now for three years. I’ve been on a Mediterranean diet and didn’t get radiation or Lupron shots. My last PSA was 0.17

Stage 4, Gleason 9, mets to iliac bone and regional lymph nodes. I took a digarelix (Firmagon) injection monthly along with 1gram abiraterone and 5mg prednisone, daily, for about 2.5 years. Usual SE with hot flashes, muscle wasting and loss of stamina. Switched Oncs and new one put me on Eligard inj every 3 months and abiraterone 250mg and 5 mg prednisone daily with LOW-FAT breakfast. He switched me because I was complaining about the long monthly drive and painful injections with the digarelix. But after just a few weeks of the change I started developing muscle pain in my glutes (butt) which eventually extended down into my hamstrings. Made walking and even standing straight up difficult and painful. Doc stopped the abiraterone (eligard still in the system) and the symptoms subsided. Now he has put me back on the 1gm abiraterone regime with another injection of Eligard. It has been 3 weeks and the muscle pain is starting, again. Something about Eligard or the combo with abiraterone ... my body does not like. I have asked him if he would order relugolix (oral version of the digarelix I was on before) but he shied away because of the difficulty they have had getting insurance approval. I will suggest strongly that we discontinue the Eligard and start me back on the digarelix injections pending his submitting for relugolix approval.

You had no treatment for your PC? So your PC was detected with a PSA test Only? No biopsy? If I had a lymph node with cancer I sure would have my PSA test at least every 6 months. Three years seems VERY risky as to time for a test. You were spared the horrors of Lupron. Really life destroying at the very least, you have no idea. Some have commited suicide on this, not common but it does happen. By your post, you have lowered your PSA with diet only? what was your PSA at diagnosis. ?
Lacco

Abiraterone reduces hormones produced anywhere in your body (endocrine system, i.e, thyroid, parathyroid, adrenal, etc.) Lupron reduces hormones in your testicles.

Me too, I started taking only 1 250 and got great results.

It’s pretty clear that your problem is abiraterone not Eligard. You could request Orgovyx again, it has been approved by almost all insurance companies. Ask him to at least request it. He could give you a one month Eligard shot, So you can see if you can get Orgovyx.

Some people that are on Abiraterone have dropped back to three pills instead of four to try to resolve the side effects problems. See if your doctor will allow you to do that and if it makes a difference. You don’t want to sacrifice your PSA when you try this, however. I tried it and my PSA went from .2 to 1 in 18 days.

I found that switching from abiraterone to Darolutamide was much better for me. I was on Abbie for 2.5 years but since Switching my PSA has been undetectable for 18 months, in the 2 1/2 years I was on Abbie I was only undetectable one month. Your doctor might let you switch to Enzalutamide because it is cheaper, but it does have more side effects.

Don’t really expect that long-term orgovyx will work any different than Eligard. They do the same thing which is reduce your testosterone dramatically.

Hi Jeff,
I was diagnosed with two Gleason score 8 prostate adenocarcinomas and one with a score of 7, measuring 7 mm, 4 mm, and 1 mm respectively. All tumors were confined within the prostate and had not spread to other organs or lymph nodes. However, a PET/CT PSMA scan suggested possible metastasis to two ribs.

After consulting with a doctor, she explained that in order to confirm bone metastasis, a bone biopsy would be needed. However, since rib bones contain few cells, even a biopsy may not definitively confirm metastasis. Therefore, the bone biopsy was not pursued.

After careful consideration, I decided to proceed with treatment as if it were metastatic prostate cancer and chose proton radiation therapy. On March 18, I received an Eligard injection, and this month I am scheduled for 32 proton therapy sessions.

I noticed that many of you consulted with medical oncologists, surgical oncologists, and radiation oncologists before making your treatment decisions. After I chose proton therapy, my radiation oncologist later mentioned that the rib lesions may not actually be cancerous. During the discussion of my proton therapy plan, the possibility of including rib proton therapy was also considered.

Since I have not yet seen a medical oncologist, I am wondering whether I should consult one after completing the 32 proton therapy sessions, or if I should find a medical oncologist at the proton therapy center to serve as my follow-up doctor for post-treatment care.
Please give me Your comments and suggestions .
Thanks so much.
Lifu Tang

Thanks! I don't know whether it's the abiraterone (which I took in combo with digarelix for 2.5 years with no problem) or just the combo of abiraterone with the leuprolide. I suggested a possible switch to darolutamide citing the results of the Titan study ... but I think he's thinking darolutimide is a triple therapy ... with ADT and doxetaxel (as in the studies). I'm not all that interested in getting chemo. Are you on triple therapy?

I just read results from a different study using just darolutamide and ADT.
Phase III ARANOTE Trial: These results confirm the efficacy and tolerability of darolutamide plus ADT in patients with mHSPC, demonstrating clinically and statistically significant improvement in rPFS and a favorable safety profile consistent with prior phase III darolutamide trials.
Maybe this will help move him to try the different combo?

I am a Gleason 7 with BRCA2. So far, I’ve only had one metastasis and I’ve had it zapped. My PSA has stayed undetectable for 18 months so I’m not gonna be up for chemo yet.

A short history

In 2010 I was 62 and a biopsy showed Gleason 3+4. Had surgery, after surgery they told me it was a 4+3. It was only stage two. 3.5 Years later it came back and I had radiation. 2 1/2 years later it came back and I went on Lupron. I became castrate resistant 2.5 years later and added biclautamide. 1 year later went on Zytiga, which kept my PSA down for 2 1/2 years., After some AFIB Issues I switched over to Nubeqa, The last 18 months I’ve been undetectable. I became stage four about six years ago. I did not find out I was BRCA2 Until four years ago.