1. < Prostate Cancer

Abiraterone+Lupron vs (Clinical Trial) Apalutamide+Lupron

Posted by dwb1 @dwb1, Apr 11 6:55pm

Had RP in Jan for typical 4+3=7 PC. PSA is now 10.3 and PSMA Pet shows metastasis to retroperitoneal and hilar lymph nodes which is a very atypical progression. Pelvic bowl, organs, and bones are clear. My oncologist has suggested the two treatment options listed in the heading. Does anyone have experience or comments regarding these two options?

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drmccoyce | @drmccoyce | Apr 14 2:02am

I have stage IV Prostate Cancer:
I have been on Lupron since 2012 and experienced side effect: hot flashes, weakness, breast growth, fatigue. About 2021, had a lot of scans: body scans, head scans and was diagnosed with stage IV Prostate Cancer. Had a couple procedures, then started Abiraterone 1000mg daily with Prednisone 5mg daily. I still get Lupron injection every six months.

REPLY
starman | @starman | Apr 15 7:02am

I’m taking 120 mg Apaludamide and Lupron x 4 months. My psa is 0.02. I get the usual side effects but the psa has been negligible for 2 years. So far so good. I hope for many years of success.

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tenders2023 | @tenders2023 | Apr 15 8:05am

I had Robotic Radical Prostatectomy and still had a PSA of 2.1 one month after surgery.
Immediate PET scan showed metastasis to iliac lymph nodes a bunch of internal nodes and the left para aortic lymph nodes.

Gleason 9 (4+5) stage 4A
I was started on Lupron 3 month with accompanied Bicalutamide for one month to address the Lupron Testosterone spike.

Currently on Lupron and Abiraterone (Zytiga) and 5mg Prednesone.

One thing to look out for is Liver enzymes, after doing fine for 3 months on this combination they just doubled.

Although I don’t have a lipid issue, my GP has me on low dose of Atorvastatin… I am discontinuing the statin in hopes my liver enzymes return to normal.

Other than that, I cry easily but am quite resilient… I laughed when the Dr said it makes you less resilient…

I didn’t say so, but look what I’m going through, the decisions I’ve made and tell me that again.

I’m May, I get the radiation consultation in preparation for that step of the journey.

I can handle the ADT therapy and all that it entails… I want to live!

Side effects of ADT
Brain fog : Minimal (still sharp as a tack)
Lethargy: Not noted
Labile mood: Yes (manageable)
Hot Flashes: Yes (who cares)
Libido: Yup, still got it though diminished slightly.
Testicles: 1/3 size from normal
Erections: Nope, lost those nerves, working with MSK to rectify

Penis: If it means anything to you, start on a daily, low dose of Tadalafil 5mg, when that aspect of your life rekindles you will thank yourself for doing so… to not, is to face atrophy… and there is no recovery from that.

I also used the pump a month after the catheter was removed and I retained most of my length.

Full bore survival mode!
Love to live, live to love.

IMPORTANT
Most men will also be put on prednisone, for some individuals Thai will cause glucose issues. So far I have not had this experience (thankfully)

I excercise, keep active it helps enormously!!!

It will also keep blood moving to the testicles they will not be as small as if you don’t.

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1 reply
Moderator
Colleen Young, Connect Director | @colleenyoung | Apr 17 6:14pm
In reply to @tenders2023 "I had Robotic Radical Prostatectomy and still had a PSA of 2.1 one month after surgery...." + (show)
@tenders2023

I had Robotic Radical Prostatectomy and still had a PSA of 2.1 one month after surgery.
Immediate PET scan showed metastasis to iliac lymph nodes a bunch of internal nodes and the left para aortic lymph nodes.

Gleason 9 (4+5) stage 4A
I was started on Lupron 3 month with accompanied Bicalutamide for one month to address the Lupron Testosterone spike.

Currently on Lupron and Abiraterone (Zytiga) and 5mg Prednesone.

One thing to look out for is Liver enzymes, after doing fine for 3 months on this combination they just doubled.

Although I don’t have a lipid issue, my GP has me on low dose of Atorvastatin… I am discontinuing the statin in hopes my liver enzymes return to normal.

Other than that, I cry easily but am quite resilient… I laughed when the Dr said it makes you less resilient…

I didn’t say so, but look what I’m going through, the decisions I’ve made and tell me that again.

I’m May, I get the radiation consultation in preparation for that step of the journey.

I can handle the ADT therapy and all that it entails… I want to live!

Side effects of ADT
Brain fog : Minimal (still sharp as a tack)
Lethargy: Not noted
Labile mood: Yes (manageable)
Hot Flashes: Yes (who cares)
Libido: Yup, still got it though diminished slightly.
Testicles: 1/3 size from normal
Erections: Nope, lost those nerves, working with MSK to rectify

Penis: If it means anything to you, start on a daily, low dose of Tadalafil 5mg, when that aspect of your life rekindles you will thank yourself for doing so… to not, is to face atrophy… and there is no recovery from that.

I also used the pump a month after the catheter was removed and I retained most of my length.

Full bore survival mode!
Love to live, live to love.

IMPORTANT
Most men will also be put on prednisone, for some individuals Thai will cause glucose issues. So far I have not had this experience (thankfully)

I excercise, keep active it helps enormously!!!

It will also keep blood moving to the testicles they will not be as small as if you don’t.

Jump to this post

Resilience means a lot, @tenders2023. Yes, you are.

REPLY
dwb1 | @dwb1 | Apr 17 8:06pm

Thanks to everyone for your feedback. It has been most helpful. My final decision on treatment comes Tuesday. I think I'm going to pass on the clinical trial because it would mean going through another month of tests and scans. I am just ready to get started with treatment. I just hope hormone therapy is enough to put this beast to sleep. I always question are we doing everything we can.

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hbp | @hbp | Apr 17 10:59pm

I have been on the apulutamide -Erleada clinical trial for 30 months and I feel very fortunate that I got in the trial and that I received Erleada and not the pracebo . I had 6 months of Erleada and ADT meds then RP then 6 more months of these meds and then 17 months of no meds. I am G9, CR, advanced PC, now 77 years old. I believe that my treatment in this trial and at UCLA has given me the best chance for more years of a quality life.
I am thankful that my doctor recommended this trial and got me in the trial and that I listened to him. I take this cancer very seriously and not just an inconvenience.

REPLY
gman999 | @gman999 | Apr 26 9:44am
In reply to @hbp "I was on Lupron and Erleada for 13 months with Robo surgery in the 6 th..." + (show)
@hbp

I was on Lupron and Erleada for 13 months with Robo surgery in the 6 th month. The goal was to keep me alive. G9, CR, locally advanced. It not only worked but the surgery and the meds were manageable, but clearly I would not have done either but for this life threatening cancer. I am now 30 months post the treatment beginning, off of all drugs for 17 months, PSA .01. The manageable side effects were, hot flashes, sleep difficulties, loss of muscle and gained 30 lbs, slight brain fog, but as I said, these were manageable and not as difficult as many people have on chemo. My goal is to live as long as possible and reasonably free of pain. I am now 77. Good luck to you and to all.

Jump to this post

One day at time. There are many of us in the same shoes.

REPLY
dwb1 | @dwb1 | Apr 26 12:58pm

Update - I decided to go with Lupron + Xtandi after much research, consultation with my oncologist and a second opinion from Cleveland Clinic. Started taking the Xtandi three days ago and received my first three month shot of Lupron yesterday. So far so good, I guess we'll know how it's working soon. Anyone been on this combo for a while?

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