Stage 4 prostate cancer treatment options

Posted by safari1949 @safari1949, Nov 17, 2019
  1. 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.
@papabill

I am scheduled to start Lupton next week, but I'm a bit apprehensive about going that route after reading all the side effect reviews on various sites. Folks here seem very positive, so if appreciate any input on how this regiment effects quality of life. Just diagnosed date 4 Gleason 10 PSA 15. I'm 72 this Monday. Have been on bicalutamide for just one week and I'm scheduled for a CT abdomen and Pelvic bone scan in about two weeks. Any input would be appreciated. Just new to this. Thanks PapaBill

Jump to this post

I have had. 3 Lupron shots , I feel that I don’t want anything feeding my prostate cancer so I elected to have them and yes there are effects after eventually they go away stay strong with weights and walking daily ..you will be fine

REPLY
@vernonkent

@philnob I am wondering the same about weight gain. I started Lupron a couple weeks ago. Within a week noticed weight increase of 3-4 pounds. Now watching diet and exercise carefully, but wondering what to expect.

Jump to this post

I had only 1 Lupron shot but I had no weight gain.. .. at my 6 month check-up the doc decided I did not need a second shot and said the effects of the 1 shot were still working some in my system… Ken

REPLY

Does anyone have experience with enaxutimide as a treatment for stage 4 prostate cancer?

REPLY

Just a heads up on the use of Lupron. I was diagnosed with Prostrate Cancer October 2018. I went to Mayo Phoenix for treatment. They began with Lupron injection and 2 months later 20 applications of proton beam therapy. I had my second lupron injection last April and my last one in November.
The research that I've seen on cutting off your testosterone is that you will lose bone mass. It's a given. Calcium, vitamin D, and exercise helps, but you need to have your bone mass checked. Mayo checked mine in November. The result showed I was almost 3 times more likely to have a bone fracture then an average person. Last week I had an infusion of Reclast to protect my bones until my testosterone kicks back in.

REPLY
@waynen

Just a heads up on the use of Lupron. I was diagnosed with Prostrate Cancer October 2018. I went to Mayo Phoenix for treatment. They began with Lupron injection and 2 months later 20 applications of proton beam therapy. I had my second lupron injection last April and my last one in November.
The research that I've seen on cutting off your testosterone is that you will lose bone mass. It's a given. Calcium, vitamin D, and exercise helps, but you need to have your bone mass checked. Mayo checked mine in November. The result showed I was almost 3 times more likely to have a bone fracture then an average person. Last week I had an infusion of Reclast to protect my bones until my testosterone kicks back in.

Jump to this post

Thanks for the info. More and more it looks like I'll be seeking other options before going this route. Appreciate your response. Blessings

REPLY

The problem is how to treat the more advanced levels of the cancer, i.e. Gleason score of 8 or higher. That's when they feel that ADT becomes important. My radiation oncologist told me on my first visit that using Lupron with radiation increases my chance of "survival" by 20%. It brought it up from 60% to 80%, and I didn't have any secondary spread of the cancer. Needless to say that caught my attention. So, my wife and I are willing to live with the issues that come with Lupron.

If you want to explore other options, you could look into new treatments for people who inherit mutations in DNA-repair genes found in advanced prostate cancers. If you go to Practice Update Advanced Prostrate Cancer and look at the video expert opinion section. There's a February 25 interview on Inherited DNA Repair Defects. I don't know if you've had Genome testing, but about 12% of men with advanced prostate cancer can have these defects and can be treated without radiation or surgery. It wasn't a part of any discussion I had with any doctor.

REPLY
@waynen

The problem is how to treat the more advanced levels of the cancer, i.e. Gleason score of 8 or higher. That's when they feel that ADT becomes important. My radiation oncologist told me on my first visit that using Lupron with radiation increases my chance of "survival" by 20%. It brought it up from 60% to 80%, and I didn't have any secondary spread of the cancer. Needless to say that caught my attention. So, my wife and I are willing to live with the issues that come with Lupron.

If you want to explore other options, you could look into new treatments for people who inherit mutations in DNA-repair genes found in advanced prostate cancers. If you go to Practice Update Advanced Prostrate Cancer and look at the video expert opinion section. There's a February 25 interview on Inherited DNA Repair Defects. I don't know if you've had Genome testing, but about 12% of men with advanced prostate cancer can have these defects and can be treated without radiation or surgery. It wasn't a part of any discussion I had with any doctor.

Jump to this post

Thank you. Just getting started and have had very few discussions with doctors other than them ignoring my questions and just scheduling procedures and medications as if I would blindly go down any road. This site and my own research have opened up actreadure trove of information. Feeling more positive as I go along. Postponed my Lupton until after the CT scan and bone scan results come back. I've been dealing with undiagnosed symptoms for many years, so another week won't matter much in the scheme of things. Blessings.

REPLY
@stoney1967

I have had. 3 Lupron shots , I feel that I don’t want anything feeding my prostate cancer so I elected to have them and yes there are effects after eventually they go away stay strong with weights and walking daily ..you will be fine

Jump to this post

Thanks. Working on it.

REPLY
@papabill

Thank you. Just getting started and have had very few discussions with doctors other than them ignoring my questions and just scheduling procedures and medications as if I would blindly go down any road. This site and my own research have opened up actreadure trove of information. Feeling more positive as I go along. Postponed my Lupton until after the CT scan and bone scan results come back. I've been dealing with undiagnosed symptoms for many years, so another week won't matter much in the scheme of things. Blessings.

Jump to this post

You are right. There's a need for knowing what's the right thing to do, but you do have some time.

REPLY
@waynen

You are right. There's a need for knowing what's the right thing to do, but you do have some time.

Jump to this post

Thanks. I am looking forward to the time I have!

REPLY
@norske46

Does anyone have experience with enaxutimide as a treatment for stage 4 prostate cancer?

Jump to this post

@norske46, do you mean ethosuximide, the anticonvulsant?

REPLY

I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from bicalutamide.

REPLY
@norske46

I understand that enzalutamide (previous spelling incorrect) is a another hormone drug a step up from bicalutamide.

Jump to this post

Ah, yes. Enzalutamide (Xtandi®) makes more sense. @donnelson started this discussion dedicated to the topic here:
– Enzalutamide (Xtandi): Anyone have experience with this drug? https://connect.mayoclinic.org/discussion/xtandi/

Seems like not many in the group have been prescribed enzalutamide. Is this something your oncologist is recommending for you Norske?

REPLY
@colleenyoung

Ah, yes. Enzalutamide (Xtandi®) makes more sense. @donnelson started this discussion dedicated to the topic here:
– Enzalutamide (Xtandi): Anyone have experience with this drug? https://connect.mayoclinic.org/discussion/xtandi/

Seems like not many in the group have been prescribed enzalutamide. Is this something your oncologist is recommending for you Norske?

Jump to this post

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.

REPLY
@norske46

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.

Jump to this post

Oh, 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?

REPLY
Please login or register to post a reply.