Stage 4 + Mass Blocking Urethra

Posted by beatpc123 @beatpc123, Feb 10 1:14pm

My grandparents aren't technologically savvy and having some medical background, I have been helping my grandpa with as much as I can since he was diagnosed with stage 4 prostate cancer May of last year that has spread to the bone.

We have had several incompetent/uncaring doctors telling us "well hes 89 so *shoulder shrug*" and our questions never get answered. It is even harder since I live 1200 miles away from them, so I am here to ask people with any experience for help.

My grandpa has had the eligard shot 2 times now. Apparently since the last bloodwork the PSA has increased and the mass has grown. Now the oncologist is suggesting generic Zytiga. He will be starting that Tuesday. Is it normal for Elegard not to at least stop the PSA from going up? From what I have read here, usually it goes down. What is your experience with Zytiga (abiraterone acetate).

Also, for 8 years now my grandpa has been complaining of issues with his urethra and constipation. There no point to go into detail, but lets just say I think all of this could have been avoided if proper testing and treatment was done when he first complained of issues. Since being diagnosed, he has had tubes put into his kidneys so they can drain. He can walk very well and does all of the resistance exercises every day. However, his biggest wish is that he can get the bags removed, but I know that will only happen if the cancer reduces in size/unblocks his urethra. Has anyone been in this same predicament and had treatment (medication) that in the end helped them get the tubes removed? They say he is too old/high risk for surgery so that is out of the window.

Thank you.

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Thank you for caring for your family and reaching out, these are not easy situations. I can not comment on the crux of your question as it relates to the urethra, but to the question of "should Eligard have a positive impact to reduce PSA", in most cases the answer is "yes" if the prostate cancer is hormone sensitive (also called castrate sensitive). The cancer can mutate (and does) to where it becomes hormone resistant (also called castrate resistant) (and Eligard and Zytiga are not principal care) and at that point other drugs such as androgen receptor inhibitors should be explored. I wish I could share more information as it relates to your situation, but you are in good hands and someone on here should be able to chime in.


Thank you for all the feedback, especially about being hormone sensitive. I had no idea. I was curious about the difference with Zytiga and Enzalutamide. It sounds like you kinda answered that question with your explanation. I guess now I am more curious why the doctor went from eilgard to Zytiga when the eligard isnt working. On top of both, my grandfather has had heart issues in the past and I thought since Zytiga has been linked to causing heart problems that they would prescribe enzalutamide. I know Enz comes with its own side effects, but seemed to make more sense purely in the context of prior comorbidities.


Enzalutamide stopped working for my bone mets so in Jan 24 did first of six injections of Radium 223 Google it

I am 74 with Gleason 8, metastasis to lymph nodes, seminal vesicals and bladder neck. Have had 20 fractions of Tomotherapy that ended last year Feb. I can provide some insights into my experience with Zytiga (abiraterone acetate) and Eligard (Leuprolide). I really don't know which of these two drugs is responsible for the significant reduction of my PSA to 0.02/0.03, as I have been consistently taking both Abiraterone (per oral) and receiving Leuprolide (Eligard) 22.5/Zoladex 10.8 injections every three months for the past several months. Previously, I was taking Abiraterone at a dosage of 1000mg on an empty stomach, but my doctor recently adjusted the prescription to 250mg after a substantial breakfast (he even asked me to have butter with my breakfast, and when I told him my wife doesn't allow that, he put it down in the clinical notes, heavy breakfast with butter 🙂 ).

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