Stage 4 prostate cancer in my bones

Xtandi (Enzalutamide) can have fatigue and other Side effects for many users. Nubeqa (Darolutamide) has no side effects for most people It also works very well with chemo.

You don’t give any idea about how aggressive your cancer is. You don’t say your Gleason score or your PSA and initial treatment. It sounds like you had metastasis to the bone, Which really must be treated. If you have more than five metastasis then chemo is really the normal choice after Pluvicto and xofigo.

You may have negative side effects from chemo for the first couple of months, but then you get over it. It will give you a significant chance of a longer life.

Prostate cancer to the bone can be very painful. My father died of prostate cancer and in his last few Weeks was unable to communicate because he was on so much morphine, because of the pain. When I was young, he had his teeth ground down and crowned without Novacaine, he had that much pain tolerance. He would come home at night after that and eat dinner with us? I sure could not do that. Treatment is better than the alternative.

Thanks so much for info! I had gone to same urologist for 11 years
and never mentioned cancer; got second opinion, and that's when I found out I had metastatic prostate cancer in bone! Again much appreciated for response.

Hi,
Is the metastatic cancer treatable with external beam radiation? Some of the newer ADT drugs like Orgovyx are suppose to have less side effects and come in a daily pill form. I would check with your Oncologist.

Dave 3+4

You have more experience than almost everyone that is on this board. By taxane I take it you mean docetaxel (Taxotere). The new regimen suggested is just the second level of taxane drug. Cabazitaxel (Jevtana) is reported to have the same side effects as docetaxel. Expect more of the same with the new chemo drug. The carbon platinum is usually given with all taxanes to enhance effectiveness, so you probably also had that in your first round of chemo. Discuss with your doctor what to expect if this should be slightly worse / better than the first round. Your experience in the first round (good or bad) is probably the best indicator of what to expect with the new drug.

Thanks for responding! Did not have carbon platinum with first round of docsataxel; my experience wasn't too bad; it's just the triple combination of xtandi, cabazitacel , carbon platinum side effects worries me, but he wants to be aggressive with this cancer. Again, thanks!

@brittdan You should be okay based on your chemo experience in the first round. As Jeff mentioned of the three drugs (Xtandi, Erleada, Nubeqa) most patients find Nubeqa has fewer side effects. They all do the same thing, about equally effective and expensive ($10K+ mth in USA). Your doctor probably will not mind the substitution. The chemo with the carbon platinum is required for effective treatment and you have already exhausted almost every treatment.

@jim18 thanks!!