Got some answers for stage 4 prostate cancer

Posted by beaquilter @beaquilter, 2 days ago

We had our first Urology Oncologist appointment today at UNC.
Finally have a "plan" after the PSA test started it all 5 weeks ago!
PSA was 251, CT scan showed it spread to lymph nodes, Biopsy showed gleason groups of mostly 5s, PSMA PET scan showed in lungs and bones and lymph nodes near lungs as well.
My husband is 55 and in otherwise good shape, eats right, exercises etc.... has always done that, though now he's super strict about it! No sugar, no carbs, he's thinking about cutting out fish and going completely vegan! (He only ate salmon this last month and an AWESOME "salad" with cilantro, bean sprouts and other things. He's also taking supplements now.
So here's the plan:
ADT injection (Degarelix) soon, either this week or next.
ADT pills (Zytiga with Prednisone)
Later Chemo, 6 sessions 3 weeks apart.
Radiation is maybe later, they are not sure yet, they want him to start with these things first and see how it changes levels.
They did say that what used to be "months left" is now years, that about 50% make it 4 years.
Emotionally we're kinda numb, my husband says he feels apathetic.
He was against the hormones a month ago when it was all new to us, but now we know there's really no other way, Pluvicto will only come into the picture if the cancer is testosterone resistant, so they're guessing 18-24months, but will keep testing everything often.

I'm hoping the ADT injection will make him feel better (pee less often) and no side effects or minimal. Then it'll give him the mental energy to fight! Physically he's in good shape, but mentally he wants to give up already and die.
We have a good church support and friends who are praying for us and checking in, and telling him to fight for himself, for me and for our 4 kids (ages 9-22!)

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

kujhawk1978 | @kujhawk1978 | 8 hours ago

So, off to a good start with triplet therapy.

If no financial toxicity involved with Orgovyx, would definitely discuss with my medical team. Advantages:

it doesn't have the flare that Lupron does
faster to castration
higher sustained castration rates
quicker recovery when stopping though with his clinical data, not sure intermittent therapy is in the cards
No visits to the doctors office to get the shot(s).

Same side effects though, no T is exactly that.
It does have a lower CV side effect profile

@northoftheborder is right about the lutamides...

@jeffmarc is right about life expectancy, the advances brought about by medical research make those guestimates out of date. More and more I see where in situations such as his, taking out the mother ship (prostate) is part of reducing the tumor burden.

I'm with @heavyphil on the out of the box treatments, he is not there, trust the science.

In my experience, best ways to mitigate the side effects:

Exercise
Diet
Managing stress

all in moderation...

Thought for the day…”Diligent monitoring and proactive treatments have served me very well. When your cancer advances after your original treatment, it's a lifelong hobby.”

Kevin