Treatment for Prostate Cancer Metastasized to Bones

I'm sorry to hear that. I hate pain meds too.

I've been trying for over a year to slowly titrate off Pregabalin (Lyrica) because it increases my feelings of numbness, which are already bad enough after the spinal damage. But every time I get it down (gradually reducing over a month or two), it seems ok for a week or so and then pain roars back like an express train.

I've decided to give up the struggle for 2023, but might try again in 2024.

Russ hates it ! Hurts bad pain joints and back ! Who wants to live on pain meds it sucks 😞 not sure what he will decide ! Taking a trip to Arizona for nice weather ! God bless 😊

Rick, I have CR aggressive, locally advanced, gleason 9 PC. I had surgery 6 months after starting these meds and 6 months after, all part of a Jansen clinical trial at UCLA. For the last 10 months and maybe more, my PSA has been .01 The reason I stopped the meds is because of the clinical trial procedure and because my PSA did not rise. Hence, I was helpful to Jansen in their trial and Jansen was helpful to me. My doctor advised me that in time the PSA will rise and then they will put me back on Lupron and Erleada and perhaps more ( if it doesn’t work they will switch me to something else) 2 years ago my prognosis was 2-4 years and I am hoping and working hard to make it much more. Good Luck to you!

What were the indications that you could stop taking your meds? I have been on Erleada and Zoladex for almost two years and my PSA is basically non-detectable. My Oncologist has never suggested that I stop any meds. I find the Erleada side effects very difficult to tolerate.

I'm 55. Diagnosed with PCa and mets to hip, L5 and sacrum in January 2023. I'm on abiraterone and Prednisone daily, with a lupron shot every 3 months. I get hot flashes occasionally but they are such a minor side effect for me. I don't have any side effects from the lupron shot other than the expected minor pain from the injection. My PSA was originally 359 and it's been around .11 for the past 6 months. I'm stable and generally feeling great.

Thank you -- that's very interesting. All of the references I can find for CLTA-4 with prostate cancer refer to metastatic castrate-resistant prostate cancer (e.g. your PSA is rising even with ADT). So far, mine is castrate-sensitive (ADT is keeping the PSA undetectable), but it's good to know what the next steps might be if/when ADT+Erleada stop working for me.

https://clinicaltrials.ucsf.edu/prostate-cancer
The discovery of CLTA-4 is changing cancer treatment including prostate cancer. Especially with metastatic prostate cancer the clinical trials are worth checking into.

My prostrate cancer once found metastasized to my bones too ( thats another story. I had 6 rounds of chemo. I'm currently on Abiraterone and Prednisone. I will start back on Zometa in about a week, this helps with the bones. I get an injection of Eligard every 3 months.
Sides effects- tiredness, muscle loss (due to testosterone removal),hot flashes and bone pain every so often. I had some issues with chemo brain but memory has returned.
Wish and hope for the best for us all

I have been on Lupron for 22 years. In the beginning, PSA rose a tad , but by combining the Lupron with Casodex, I was quickly in remission. Within a few months, I was off the Casodex and. have been on just Lupron ever since with little to no side effects. Hot flashes vanished long ago. Is Lupron no longer presented as an option?

From reading this discussion, I realise that I'm lucky to be tolerating Erleada (Apalutamide) and Firmagon (Degarelix) relatively well. I have one bad day (flu-like symptoms) and two so-so ones after each monthly Firmagon shot, along with some swelling at the location of the shot, and every afternoon I have to lie down for an hour or two, but otherwise I don't think the meds are affecting my life nearly as much as the after-effects of the spinal-cord compression and resulting physical rehab.

I find that lightly icing the location of the Firmagon shot periodically for a couple of days helps to keep down the swelling. If you have castrate-sensitive metastatic prostate cancer, the Titan study was a pretty strong vote for continuing with ADT and Erleada if able, because both 5-year overall survival and progression-free survival (e.g. not needing chemo) were dramatically improved.

Source: https://pubmed.ncbi.nlm.nih.gov/33914595/