Treatment for Prostate Cancer Metastasized to Bones

On Xtandi since Jan tiered some days easy to swallow no real side effects Xgeva too

PSA dropped from 9.3 to 1.7 but recently gradual rise to 4.5

Going to learn about clinical trial at PMH

Does Dr. Kwan indicate that this will get rid of the cancer? What is his prognosis?

I just don't understand why I'm only getting Erleada and Eligard and why the Urologist here isn't recommending the 'triple therapy'...I have an appointment in 2 weeks and will ask him...
What about Immunotherapy? Is that an option?

How healthy are you overall? If you are elderly with multiple other health issues then chemotherapy my be too rough on you. If you are reasonably otherwise healthy You definitely need to go elsewhere for that 2nd.opinion. My prognosis from the oncologist was 2-5 years. Immunotherapy doesn’t usually work for most prostate cancers but that option is still out there for some.

I was pretty healthy..no health problems at all. I was a very active cyclist and hiker.

It can make a significant difference if your city is big enough to have a dedicated Cancer Centre, like my city has here in Ontario. Instead of talking to just one specialist, you have a whole team of medical professionals and services available, and many of the doctors are often researchers and med-school profs as well. When I had minor bladder damage from radiation, for example, they just sent me to a urology oncologist at the same Centre, instead of making me go through a long referral process.

Even just having a dedicated phone line where I can call and discuss my symptoms and concerns between meetings with my onco team is a big deal, and Cancer Centres are also well positioned to get you into studies and trials.

If live within an hour or two of a Cancer Centre and you're not under its care, I strongly recommend finding out what you have to do to get in (I was in hospital as a critical-care patient, so they enrolled me automatically). Obviously, the same applies to somewhere like the Mayo Clinic or its satellite locations if you're in the U.S., to give a nod to our kind hosts here. 🙂

Calgary has the Tom Baker Cancer centre which deals with all Cancer issues, but when I asked if I should see an Oncologist, the Urologist said 'not yet'..

Calgary also has the Prostaid Support Group. They sent me the link for Dr. Eugene Kwan.

I guess I am an otherwise healthy man, and if Dr. Kwan is right, then I should be getting the Triple Therapy. In his video he says this is a 'curative' solution if it is done right away.

I hope you get into the Tom Baker Cancer Centre in Calgary soon. I don't know what they'd be waiting for (I didn't have to wait for anything here in Ontario).

Note that "curative" refers to doses and intent, not result.

For example, I got a "curative" dose of radiation to my prostate (the normal max, 60 Gy) even though I'm stage 4 like you. That doesn't mean I'll be cured; only that it's a dose that oncologists use when they're trying to prolong a patient's life (curative intent) rather than the lower dose that they'd use just as-needed to help manage pain (palliative intent).

"Curative" isn't always good — it means that the patient is more likely to suffer pain and unpleasant side-effects (like the radiation damage I've experienced to the bottom of my bladder), so they don't want to do it if the chances of significantly prolonging life are low, because it will just cause unnecessary suffering and harm the quality of the life that the patient has left. I'm thinking of a friend's case — I don't disagree with his decision (he was only 60, and I'd probably have done the same) but I saw extra chemo and CAR-T really lower the quality of the last few months of his life after his lymphoma started to spread again.

(As always, layperson writing here.)

Which is better Chemo or 177LU?

One is one set every 3 weeks 177 is 6 injections spread out

FEEDBACK NEEDED QUICKLY please low load bone mets in spine but Xtandi not working as much after 9 months

@melcanada, sorry to hear the Xtandi is no longer as effective. What did you and your cancer team decide to do next?

Looking at Clinical trial at PMH 177 lu branch or chemo branch TBD Deciding wheter to go downtown Toronto or just get chemo at Credit Valley Hosp nearby