Stage 4 prostate Cancer: Firmagon + Abiraterone?

Posted by vickyjayne @vickyjayne, Sep 24, 2022

I have a question - my brother has stage 4 prostate cancer metastasis to bones. He has had 10 sessions of radiation followed now with Firmagon Shot. He has had 3 of these shots his Psa was at 1000 and now is at 2.7. His onocologist would like him to start next month on Abiraterone tablets with Prednisone or his other option is Enzalutamide tablets. He will continue with the Firmagon shot monthly in his stomach. The question we are asking is the Firmagon shot sufficient at this time if his PSA keeps dropping? Why does he have to start the other hormone therapy tablets at this time. If anyone has had experience and advice on the side effects, how long will these drugs work, please let us know. Thank you

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My PSA is 1.2 after back on Zolodex Has 39 radiations 4 yrs ago but came back in L2 lumbar bone Stage 4 BUT now diagnosed as Castrate SENSATIVE to ADT not resistive. Had radiation to take out 1 inch cancer in L2 lumbar PSA stable 1.2 for over a year now

So why for you the need to go on Zytiga? your PSA was 1.2 good

My oncologist said save Enzulutimide, or Deralutimide or ? until and if we need them at a resistive diagnosis years from now. Why have side effects when there is no real advantage in my case with light disease as he says

??

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@melcanada

My PSA is 1.2 after back on Zolodex Has 39 radiations 4 yrs ago but came back in L2 Had radiation to take out 1 inch cancer in L2 lumbar

So why for yo the need to go on Zytiga? your PSA was 1,2 good

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Pre treatment it was 80 ng/ml in Mar of 2022. Gleason 7+, Lymph node ( 2) metastasis. I also had 39 radiation sessions . The prognosis is for future spread.
The current goal is to have the PSA undetectable (less than 0.01ng/ml).
So Zytiga was prescribed to achieve the lowest PSA and hope it doesn't go back up. (It's just buying time).
Sorry to hear about your lumbar issues. Sounds like you've been through a lot. Have a good day

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See https://www.cancer.gov/types/prostate/research
Also
cancer.gov survival it says regional metastasis to lymph nodes has 99% 5 year

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@spryguy

Pre treatment it was 80 ng/ml in Mar of 2022. Gleason 7+, Lymph node ( 2) metastasis. I also had 39 radiation sessions . The prognosis is for future spread.
The current goal is to have the PSA undetectable (less than 0.01ng/ml).
So Zytiga was prescribed to achieve the lowest PSA and hope it doesn't go back up. (It's just buying time).
Sorry to hear about your lumbar issues. Sounds like you've been through a lot. Have a good day

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study seer.cancer.gov stats lots on survival

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Thanks I'll check it out.
We like survival

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@colleenyoung

Good add, @msciulli.

Here's more info about darolutamide (Nubeqa) and it's recent (Aug 2022) approval:
- FDA approves darolutamide tablets for metastatic hormone-sensitive prostate cancer https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-darolutamide-tablets-metastatic-hormone-sensitive-prostate-cancer

Has darolutamide been recommended for you Msciulli?

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It has been prescribed but waiting to see if insurance will approve. Pre-PSMA scan, would have been considered metastatic, but post-PSMA are now not metastatic, but high probability of micro-metastatic and extracapsular extension, so don't know if it will fit within the tight constraints of FDA approval. Also using Orgovyx - daily pill, fewer cardiac complications and avoids the firmagon shot.

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FYI later check out Orgovyx

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@msciulli

It has been prescribed but waiting to see if insurance will approve. Pre-PSMA scan, would have been considered metastatic, but post-PSMA are now not metastatic, but high probability of micro-metastatic and extracapsular extension, so don't know if it will fit within the tight constraints of FDA approval. Also using Orgovyx - daily pill, fewer cardiac complications and avoids the firmagon shot.

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Zolodex has worked well for me with L2 lumbar castrate sensitive metastasis I also had 1 inch cancer nuked from L2

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@jfgunion

I am new to the prostate forum. I want to know how to compare brachytherapy plus possible ADT (e.g. luperon) for 3 to 4 months to radical prostectamy (hopefully nerve-sparing). Which has the greatest chance of permanent cure and which has the greatest likelihood of all side effects (especially incontinence and ED) disappearing after say 6 months.thanks

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Get it out then get on Zoladex injection for a year plus

Radiation to margins with rapid arch last 5 of 39

Else surgery Forget about sex Testosterone is the fertilizer for prostate cancer

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