Stopping Apalutamide

Posted by coha @coha, Jul 23 8:01am

My husband is considering stopping taking Apalutamide. He has been on it for about a year. He has Lupron injections every three months, and has had radiation. Any advice or experience on this would be appreciated.

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hbp | @hbp | Jul 23 10:03am

I was on Erleada and lupron for a year. I had side effects but it medically helped me. 3 years into this at
G 9, advanced aggressive high risk PC and presently PSA is good at .01. Staying alive is no longer a slam dunk and these 2 drugs are not as difficult as other drugs that we may have to take ( chemo? ). I hired experts at UCLA medical and I recognize that for treatment, they are smarter and more experienced than me. Hence, I follow their advice, but I do communicate with them so that they know what difficulties I am experiencing. This is a serious life threatening illness and prolonging a quality of life is a worthy goal!

northoftheborder | @northoftheborder | Jul 23 10:52am

There's not a single right answer here, except that he shouldn't do it unilaterally. Assuming he's discussed it with his med team, then there are a few things to consider:

- how old is he?
- does he have other serious health issues that Apalutamide could make worse?
- are the side-effects difficult to tolerate?

I was diagnosed with stage 4b oligometastatic prostate cancer relatively young at age 56, and have been on ADT and Apalutamide for nearly 3 years now. My PSA remains undetectable (< 0.01 on the ultrasensitive test), and I have at least a shot of living to old age after all, something I didn't expect when I was first diagnosed. The side-effects of ADT and Apalutamide are not ideal, but they don't interfere seriously with my quality of life. So in my case, staying on ADT and Apalutamide makes perfect sense.

If I were elderly and/or the side-effects were difficult to handle and/or they were making other conditions (like heart disease) worse, then I might make a different decision.

coha | @coha | Jul 24 10:56am

He has decided to stop Apalutamide. He’ll have his PSA tested in two months.

rick42wood | @rick42wood | Jul 24 12:32pm

I was on Apalutamide for 3 1/2 years and stopped it about 3 months ago, I had no notable side effects but my doctor took me off it because he thought it may be causing heart problems. My PSA remains undetectable but I will still take hormone injections and get my PSA checked every two months. From other posts it seems like that is the way Apalutamide works. I wouldn't worry to much about stopping it as long as your husbands doctor is aware.