Stage 4 Prostate Cancer and Hormone Therapy quit working

Xtandi stopped working after a year Did Xofigio or Radium 223 6 injections which worked PSA back up now so 2 sets of chemo of 6 gave me reaction, fluid on lungs Has to stop Now aweing direction

Should I try Daralutimide PSA 190 Feel great at 80 8 years since radiated out prostate

@9036george, how is treatment with Pluvicto going?

Yes, that makes sense, with the caveat that if you're already on one of the -lutamides and it's been working for a while with tolerable side effects, it doesn't make sense to "roll the dice" and switch to a different one, even if the dice are loaded a bit in Daralutamide's favour as @jeffmarc reports: after all, in that case you now know with 100% certainty ex-post that your current -lutamide is working (whatever the probabilities were ex-ante, before you started taking it).

OTOH, if your current -lutamide isn't keeping your PSA low/undetectable, or if you're finding the side-effects so difficult to tolerate that you've considered stopping, then it makes sense to talk to your oncology team about trying a different med. Everyone's reaction will be different, and we're fortunate that we have so many good options these days.

Darolutamide is the one to use. As the least side effects of all three, if you look at studies, we see that if fewer people drop Darolutamide than the other lutamides because of side effects. It has also been approved for mCSPS and mCRPC.

After 2.5 years on Zytiga I was undetectable for one month. With Darolutamide i’ve been undetectable for the last 11 months.

Thanks It does give me hope that mine will begin to disappear also.

Not sure. Just adding to your post that supporting 2 vs 3 types wouldn't make a big difference, because either you can or can't take any a -lutamides for the particular cancer phase you're in (supporting other types brings you no benefit). Absolutely right that if the poster has mCRPC, then Apalutamide isn't approved yet for their situation.

Cheers!

Hi there
I assumed the issuer of the post had mCRPC - yes/no? Just trying to help if this is the case. Also wanted to pass along diet and supplement routine for the same reason.
Best wishes

"Enzalutimide which apparently treats three types of PC whereas Apalutimide treats only two"

Thanks for sharing that. It's true, but it matters only if you have metastatic castrate-resistant prostate cancer (mCRPC), which is the one that Enzalutamide is approved for but Apalutamide is not.

Otherwise, if you have non-metastatic castrate-resistant prostate cancer (nmCRPC) or metastatic castrate-sensitive prostate cancer (mCSPC), you can take either (neither is approved for nmCSPC yet, as far as I know).

I’m very sorry to hear this. I’ve had much success with Enzalutimide and Firmagon mind you I believe my diet (Mediterranean) and the addition of naturopathic supplements are helping as well. Specifically, I take Pomi -T, Cucurmin, Quecetin, Super K and Vitamin D. My thinking is the supplements may boost the effectiveness of the Enzalutimide which apparently treats three types of PC whereas Apalutimide treats only two or so I was told. Just thought I would pass this along. Best wishes.

Oldfords, First 3 CT scans revealed a zillion spots, that was the first 6 months of treatment. 2 Years after another CT scan the spots/clouds lessoned by half. Two months ago, my PSMA Pet Scan reveal 9 spots. Radiation Oncologist is going radiate 3 spots year in the next few weeks. I am now 3 years, 11 months on this journey. Hope this helps.