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    Old 07-14-2018, 11:00 AM   #1
    jwbmissouri
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    need some feedback

    Hello everyone,

    I've had prostate cancer since April 2007 and have had several different procedures and medications. I was diagnosed with a fairly low psa of 4.2 however had 4 + 5 for a gleason score. I opted to have robotic surgery which was unsuccessful as I had positive margins after surgery. I had 36 zaps of radiation then started Lupron therapy every 3 months. I continued Lupron for 3 years at which time my psa was 0. I stopped it for a couple of years then all of a sudden I got a blip that my psa was starting to rise. I stayed in that mode for a few years and when the psa would rise to 3 or so I would receive another Lupron shot. This usually took a year or more to rise to 3. Then there was less time before reaching 3, so on and so forth.

    This past March I started having a terrible pain in my lower back and this turned out to be a tumor near the L-2 vertebrae. After seeing several doctors I settled on a medical oncologist that has started me on Zytiga/prednisone combo plus a Lupron shot every three months. My psa is now nearing 0 again. I feel fine, no back pain, plenty of energy, and a general feeling of being well. Anyone out there taking zytiga with prednisone I would like to hear from to see how well you are tolerating these meds.

    Last edited by Administrator; 07-14-2018 at 05:05 PM.

     
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    Old 08-02-2018, 01:57 PM   #2
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    Re: need some feedback

    Hi jwb and welcome to the Board!

    I noticed your other post, and I hope you will be able to share more of your experience. I’m thinking your case and treatment are rather unusual, and that is probably the reason there have been no responses to date. While I did very well on Lupron and two other drugs that constituted triple ADT, I never had Lupron plus Zytiga®. I am aware that they do roughly the same thing, though of course Zytiga® is much more potent, and I have heard of a few other patients who have been on this combination. While I don’t have personal experience to respond, I can provide leads to research.

    This combination seems to be becoming known as “intense androgen deprivation therapy.” I did a search on www.pubmed.gov, a US government National Institutes of Health website that catalogs published research from all over the world, for - intense androgen deprivation therapy AND prostate cancer , and got 2 hits. The older, 2014, at https://www.ncbi.nlm.nih.gov/pubmed/25311217 , was authored by a number of heavy-hitter physician/researchers who practice at major oncology institutions, and a link to a free copy of the complete paper, rather technical, is provided. Results showed a substantial reduction in tumor burden and a great reduction in androgens in the prostate tissue. However, the existence of just one paper, the other being a comment, suggests that not that much is yet known about the role and usefulness of this combination. I also tried this more complex search - ((Lupron OR leuprolide acetate) AND (Zytiga OR abiraterone acetate)) AND prostate cancer - and got 11 hits, some of which looked like they might be helpful, but most looked completely irrelevant. Again, my impression is that not much research has been done on the combination.

    I did hear a presentation by an expert oncologist specializing in prostate cancer who said that he believed that transdermal estrogen helped prevent the conversion of prostate cancer cells to neuroendocrine prostate cancer cells, a more aggressive subtype, in some patients following use of Zytiga® or Xtandi®. (Here is an abstract of a relevant paper: https://www.ncbi.nlm.nih.gov/pubmed/28804908 . A search for - (Zytiga OR Xtandi) AND neuroendocrine - yielded 9 other hits that might be relevant.) Other doctors on his panel at a conference also seemed concerned about this phenomenon, which does not seem to be a problem with the older and less potent ADT drugs. It might be something for you to watch out for and discuss with your oncologist.

    Good luck!

     
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    Old 08-02-2018, 02:53 PM   #3
    jwbmissouri
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    Re: need some feedback

    Thanks for the info IADT3since2000. Sir you seem to be very knowledgeable concerning prostate cancer and the many treatments that abound in regions and areas. I am just a novice and know about as much about it to be dangerous telling someone else what I would do in their circumstances. I will look up the information that you linked for me and especially the last one and inquire of my oncologist about what he knows. I suppose it is possible to get too much androgen therapy which seems to me would naturally cause some type of problem. Again thanks for your input and concern. JWB

     
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    Old 08-02-2018, 04:43 PM   #4
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    Re: need some feedback

    Hi again. It's not really getting too much androgen deprivation therapy but more handling the side effects that sometimes go with it. Also, these drugs and combinations are so new that the doctors are still learning about what they can do safely in different circumstances.

    You don't need to try to tell people what to do, but you are 100% qualified to share your varied experiences. I hope you will be able to do this, and thanks for sharing what you have shared already.

     
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