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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?utm_source=newsletter_10573&utm_medium=email&utm_campaign=controversies-in-onco-urology-game-changing-session-highlights-and-more-from-the-european-association-of-urology-eau-annual-meetingAs 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!
About Lupron: I would like to hear from others 1) how long do the hot flashes last after the “expiration HAHA date” of the previous injection, and 2) did any medications help alleviate these “flashes?”
My Urologist advised me to talk to my PCP about changing my antidepressant from Sertraline to Venlafaxine. I also read on one of these postings of someone taking Paxil.
Thank you for your time.
\Back on Zolodex injections PSA stable for 12 months L2 lumbar intensely radiated June 2021 3.5 cm metastatic PC Stage 4 after 5 years since 40 radiation on Prostate
Looking at other ideas if needed over time Darolutimide has been approved for metastatic castrate sensitive PC google it
My husband has stage 4 aggresive prostrate cancer which has spread to his lymph nodes 2 places in his hip and now he has liver lesions , ,, his 1st lot of chemo didnt work , thats when it spread to his liver ,, his platelets are extremely low , he has another session due tomorrow but has to have a blood test first ,, but really thats all i know apart from his oncologist told me live cancer is incurable ,,, its nearly a year since it was diagnosed ,, can anyone give me a time scale as its now very aggresive
Hi Maudie, welcome. I moved your question about stage 4 prostate cancer to the Prostate Cancer group (https://connect.mayoclinic.org/group/prostate-cancer) and specifically to this existing discussion:
- Stage 4 prostate cancer treatment options https://connect.mayoclinic.org/discussion/stage-4-treatment-options/
I did this so you can read the previous posts and easily connect with other caregivers and patients living with stage 4 prostate cancer, like @safari1949 @philnob @oumike @semeon @dedehans @leebeth @rso @norske46 and many others.
I'm sorry to hear that chemo didn't work for your husband. Have other treatment options been discussed? Is your husband being cared for at a major cancer center?
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3 ReactionsI was told yesterday after psa scan that I have advanced prostate cancer, it spread down to iliac chains, right pelvic wall,and lymph nodes to the bladder, Bony metastatic disease
My doctor wants to start hormone therapy asap. I have no symptoms, i'm going to wait and think about this. Gleason score 9, psa 289
@jsfmc, hearing that you have stage 4 prostate cancer, but have no symptoms can send one in a tailspin of emotions and questions. And then there's the challenge of treatment decisions. I moved your messge to this existing discussion:
– Stage 4 prostate cancer treatment options https://connect.mayoclinic.org/discussion/stage-4-treatment-options/
I did this so you can connect with other men like @semeon @philnob @norske46 @ken82 @waynen @safari1949 @kujhawk1978 @rso @maxvt who are walking this path with you, so you can read previous messages and ask any questions you might have.
You'll likely hear from others that you can and should take the time to think about what is right for you. Can you share what your apprehensions or concerns are about starting hormone therapy or what questions you might have about the experiences of others?
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1 ReactionMaybe news on seer dot cancer dot gov survival and other stuff
cancer dot org
Get on Zolodex to stop testosterone the fertilizer of pc
My oncologist recommended Enzalutamide and Daralutimide but I am castrate SENSITIVE so holding off as Zolodex is working When castrate resistive then other stuff
First time on a Prostate support group for me. My PSA is 10.2 and my MRI showed a level 4. It was helpful to read everybody's experiences. Thank you. My first urologist appointment since my MRI is tomorrow and I am guessing he will want a biopsy. Could anybody share any suggestions as to what I should be aware of in this process.? Scary stuff.