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Next Steps after chemo

Posted by jmbrooke @jmbrooke, 16 hours ago

Hello,
I am 52. Diagnosed in March with prostate cancer 9 Mets to bones. Mainly on sacrum. One on skull. PSA 220. Gleasons 7s &9s. I began triplet therapy in April and just finished my 4th round of chemo. My PSA is down to 9.8. I have a PSMA scan scheduled for the end of July. I guess that will tell a lot of the story, but I am trying to figure out what options I will have after chemo treatment. Appreciate any advice. Thanks

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jeff Marchi | @jeffmarc | 15 hours ago

Just so you know, The Gleason nine is the only number they count, the sevens are irrelevant. You are a Gleason 9.

After chemo, you can have Pluvicto, Another type of infusion that can kill PSMA cells all over the body. It does make you radioactive for a few days.

You would of course only do that if you find that the triple Therapy is not getting your PSA to come down.

Did they start you on Zytiga or one of the lutamides?

I was on Zytiga For 2 1/2 years and Was only undetectable one month in that period. I switched to Darolutamide I’m now 19 months undetectable after 15 years of PC. That drug worked better for me, I can’t say if it will for you, but it works great for a lot of people I know. Just something to consider if things aren’t Working to your satisfaction.

If you are on Zytiga and your PSA is not coming down enough, you could try Darolutamide. It has many fewer side effects.

At this point, there are no other drugs unless you’ve had hereditary testing And they found you have BRCA or ATM, Which can be treated with a PARP Inhibitor.

Have you had hereditary genetic testing? Has it been offered to you by a doctor? You can get it done free with the below link, if you live in the United States. Do not check the box that you want your doctor involved or they won’t send you the kit until they get in contact with your doctor. It takes about three weeks to get the results and then a genetic counselor will call you.
`
Prostatecancerpromise.org

REPLY
1 reply
jmbrooke | @jmbrooke | 15 hours ago
In reply to @jeffmarc "Just so you know, The Gleason nine is the only number they count, the sevens are..." + (show)
@jeffmarc

Just so you know, The Gleason nine is the only number they count, the sevens are irrelevant. You are a Gleason 9.

After chemo, you can have Pluvicto, Another type of infusion that can kill PSMA cells all over the body. It does make you radioactive for a few days.

You would of course only do that if you find that the triple Therapy is not getting your PSA to come down.

Did they start you on Zytiga or one of the lutamides?

I was on Zytiga For 2 1/2 years and Was only undetectable one month in that period. I switched to Darolutamide I’m now 19 months undetectable after 15 years of PC. That drug worked better for me, I can’t say if it will for you, but it works great for a lot of people I know. Just something to consider if things aren’t Working to your satisfaction.

If you are on Zytiga and your PSA is not coming down enough, you could try Darolutamide. It has many fewer side effects.

At this point, there are no other drugs unless you’ve had hereditary testing And they found you have BRCA or ATM, Which can be treated with a PARP Inhibitor.

Have you had hereditary genetic testing? Has it been offered to you by a doctor? You can get it done free with the below link, if you live in the United States. Do not check the box that you want your doctor involved or they won’t send you the kit until they get in contact with your doctor. It takes about three weeks to get the results and then a genetic counselor will call you.
`
Prostatecancerpromise.org

Jump to this post

Thank you for all the info.

Yes, I had genetic testing done and nothing was found to change treatment.

I am on Orgovyx and Xtandi. I was on Zytiga for the first three months but just switched due to impact on liver function.

REPLY
1 reply
jeff Marchi | @jeffmarc | 14 hours ago
In reply to @jmbrooke "Thank you for all the info. Yes, I had genetic testing done and nothing was found..." + (show)
@jmbrooke

Thank you for all the info.

Yes, I had genetic testing done and nothing was found to change treatment.

I am on Orgovyx and Xtandi. I was on Zytiga for the first three months but just switched due to impact on liver function.

Jump to this post

If you have issues with side effects of Xtandi don’t live with it, ask the doctor to switch you to Darolutamide. It has a lot fewer side effects and works just as well.

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