Prostate cancer and Zytiga and ZERO PSA

Posted by spryguy @spryguy, Jan 9, 2023

Has anyone attained undetectable psa while on Zytiga (Abiraterone) ? If so was the Zytiga discontinued at some point (before 24 mos) ?
I was diagnosed with Gleason 7(4+3) w P. lymph nodes metastasis. Completed 39 sessions of IMRT, 10 mos (two 6 mo. Doses) of Lupron , and 5 mos Zytiga.
Initial psa was 80+ and is now undetectable (reached <0.1 ng/ml after 60 days on Zytiga).
What is to be gained by continuing an expensive drug that has so many negative side effects?

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Yes and yes. It is quite common to have undetectable PSA’s while on the drugs. The problem is the long term side effects and taking them for as long as 2 years will mostly likely cause irreversible ones. If your treatments were for a cure you would need to stop the drugs and monitor your PSA and have scans thereafter to confirm the success or failure.

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@round5

Yes and yes. It is quite common to have undetectable PSA’s while on the drugs. The problem is the long term side effects and taking them for as long as 2 years will mostly likely cause irreversible ones. If your treatments were for a cure you would need to stop the drugs and monitor your PSA and have scans thereafter to confirm the success or failure.

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Thanks for your input. Do you have some experience with Abiraterone? If so was it successful?
I agree with your assessment and hope that zytiga is discontinue soon.
The studies don't seem to mention "CURE" when mets are present but the "PA" at Mayo Phoenix did use that term in October. We'll talk about it at my Jan 30 Appointment .
Thanks for responding.

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@spryguy

Thanks for your input. Do you have some experience with Abiraterone? If so was it successful?
I agree with your assessment and hope that zytiga is discontinue soon.
The studies don't seem to mention "CURE" when mets are present but the "PA" at Mayo Phoenix did use that term in October. We'll talk about it at my Jan 30 Appointment .
Thanks for responding.

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On it for 8 months with Lupron for biochemical reoccurrence when CT showed no cancer. Yes it was successful for bringing and keeping the PSA undetectable but once I stopped PSA returned. It is never deemed a cure to the cancer just slows its progression down giving you more years of life but less quality of life.

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@round5

On it for 8 months with Lupron for biochemical reoccurrence when CT showed no cancer. Yes it was successful for bringing and keeping the PSA undetectable but once I stopped PSA returned. It is never deemed a cure to the cancer just slows its progression down giving you more years of life but less quality of life.

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Did you return to Zytiga or another therapy?
How long did it take for PSA to register?
Have you had a PSMA Pet/CT?
Sorry for all the ?'s

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Dx stage4 N1 M0
On Lupron for just over a yrs and Zytiga for 4 months. Had RP and 40 rounds of IMRT.
Been undetectable for 10 months.
Finally did an usPSA and it was <.006
I have little to no side effects, so not in a hurry to stop em

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@spryguy

Did you return to Zytiga or another therapy?
How long did it take for PSA to register?
Have you had a PSMA Pet/CT?
Sorry for all the ?'s

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I have since had two separate rounds of salvage radiation with Leuprolide here at Mayo in 2019 and 2021. Have had multiple Choline PET Scans finding cancer anytime I am off treatment.. Am at Mayo right now. My scan done yesterday has again showed return of cancer. Doctors appointment with Doctor Kwon at 7AM to discuss where we go from here. Anytime I have stopped treatment the cancer has returned.

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Sorry your going through all that. I hope you find a treatment that destroys the PCa.
I am taking your experience and applying it to my prospective future.
The diagnosis was Feb 2022. I am bracing for the PSA test that turns this upside down
It is a subversive and resilient disease.
God bless all of us and our families.

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I am thankful for above comments when coming off of treatment. My husband wants to stop and take a break from it but Dr concerned it will return especially since the ductal prostate cancer hides itself. Your posts have told me not good to stop treatments. God Bless each one of you.

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@kittyc

I am thankful for above comments when coming off of treatment. My husband wants to stop and take a break from it but Dr concerned it will return especially since the ductal prostate cancer hides itself. Your posts have told me not good to stop treatments. God Bless each one of you.

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I don’t necessarily recommend that course. Coming off treatment and letting the poison leave the body for awhile has its benefits,quality of life,feeling better etc. Over treatment is a bad thing too. My plan is still to stay off treatment as long as I can. That’s also the only way to see if one-selves cancer might be in remission. Watch it closely and save the treatment for when it is really needed. I think family members can sometimes be selfish wanting to keep their loved ones as long as possible without looking at the quality of life the person is having. Respect the patients feelings. I hope you are able to both work through this for a mutual decision on treatments.

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stay alive stop testosterones with zolodex i have my L2 radiated taking 3 inches of metastatic out May need to do L1 and hip Going on Enzalutamide maybe as well

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