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Stage 4 prostate cancer treatment options
I have recurring prostate cancer and it has found its way to 5 different bones, including my left shoulder and two ribs on my right side. I started 6 month Lupron shots but have been told that because it is stage 4 I need additional treatment. My oncologist is recommending either Abiraterone (Zytiga) for 33 months or 6 treatments of Docetaxel chemo. She says that they look to have very equal success. With the Zytiga I will also have to take steroids, probably prednisone which I understand includes possible liver damage. Six chemo treatments seems like a better approach but I have heard Zytiiga talked about in a very positive manner. I understand it can be expensive and I do worry my prescription drug coverage could change its formulary and raise my cost significantly as well. I've already had that happen with a drug I take for Parkinsons.. Just looking for some general input regarding peoples actual experience either way.
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Here's my clinical history. When I was doing triplet therapy - ADT, Taxotere and radiation, Dr. Kwon considered adding Zytiga but based on the clinical data showing my response to the Lupron and Taxotere, he decided it was not necessary.
For some, the decision whether or not to do taxotere may be a financial decision, Taxotere is less expensive than Zytiga, Xtandi...others may not be fit enough for Taxotere and others may want to do six cycles of Taxotere spaced three weeks apart vice 12 -24 months of an additional ADT agent such as Zytiga. While on taxotere, I was also on prednisone.
Here's a link to recent discussion at EAU 2022 on doublet and triplet therapy.
https://www.urotoday.com/conference-highlights/eau-annual-congress-2022/eau-2022-prostate-cancer/138222-eau-2022-state-of-the-art-lecture-mhspc-doublet-vs-triplet-combination-therapy.html
As to the side affects, your medical team should actively monitor kidney, liver and other indicators using labs - CBCs. As to the side affects, they are listed but each of us will have varying ones and to varying degrees. For me, I mitigated them to a degree by exercising, keeping an eye on my diet and fortunately, listening to my body and when I needed to rest, just did!
When I first was prescribed abiraterone I was able to obtain a grant which covered the cost.
what joints?my knees were hurting quite a bit til I resumed my training,could tht pain be from the chemo and lupron? thanks
That sounds like me
Mayo oncologist did amazing treatments for me .
No, no pain at this time. I am trying to be good to myself while maintaining "normal" activities.
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1 ReactionOh, I see. I'm sorry to hear about it spreading to the spine. Be cautious with your activities and be kind to your back. Are you experiencing pain?
Yes, bicalutamide didn't get the job done so I will start enzalutamide as soon as it arrives in the mail. Cancer has spread to my spine and PSA has gone back up to 46.9. We need to find something to get it in check.
Ah, yes. Enzalutamide (Xtandi®) makes more sense. Seems like not many in the group have been prescribed enzalutamide. Is this something your oncologist is recommending for you Norske?
I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from bicalutamide.