My dad's update

So sorry to hear about your Dad's rising PSA ... and the frustration of it all! All that I can offer is ... please keep hoping ... for good results of the new medication! I too will be going onto Xtandi next - waiting for the delivery of the first or initial dosage today in fact!

A brief background ... I was on Zytiga in 2012 for over 5-months - and it was the first major treatment (besides Casodex and Lupron) for my return of PCa - after a 6-year timeframe of freedom from abnormal PSA readings. During the Zytiga months, my PSA climbed steadily until my Oncologist took me off that - and put me on Texotere.

I was on Texotere for 30-weeks - a total of 11-treatments - and they did work for me, that is, the PSA steadily but not dramatically dropped over those 8-months - until april of 2013. The Onco took me off the Texotere because of the associated cell destruction of that drug or chemo - to give me a break for at least a few months.

In just 6-weeks, my PSA doubled! That was about three weeks ago - and the extreme cost of the Xtandi had been in negotiation for about 10-days .... and concluded with positive results three days ago.

All we can do for ourselves (and in your case - for your Dad as well) is to keep hoping. Each PCa case is a different set of circumstances, so comparisons are difficult to make! I hope the Xtandi is the oral chemo that will help your Dad (and you as well) ... I have hopes for the same for me as well.

Keep the faith going ......... 

From your first writing of this thread, I believe you said you were from the New York area - and were looking for another Onco. Sorry I cannot help with a local (for you) recommendation of an Onco, but here are some thoughts:

My Onco (in the Chicago area) is from a fairly large office - ten to twelve doctors, more nurses than I can count, an in-house financial person very familiar with insurance companies and drug companies and a support staff - for a total of about 25 to 30 people in the medical office. One of the persons I deal with is a girl/lady of about 30-years old who has the title of Nurse Practitioner. It is a step or two above even the Head Nurse there, and she meets directly with the patients (at least in my case) every other time with my doctor meeting me every other time.

There is a very big difference between the two in their handling of the patient. The doctor (Onco) is very business-like, fairly personable and just slightly distant .... bedside manner, if you will, is a B- or so! His counterpart, the Nurse Practitioner, spends a lot more time with me, seems genuinely concerned more about me than his schedule or his next patient. And her bedside manner is easily a B+ or better! And she asks me more often "how do you feel today" when I see her!

I checked sources including Wikepedia, and the title of a Nurse Practitioner does typically have a greater education than a Registered Nurse. I believe a Masters is minimal - and some even have a Doctorates Degree.

While you're searching for a new Onco, you might want to consider or check to see if there is a staff person who would function similar to the Nurse Practitioner I have. In my case, I have a great amount of confidence in her knowledge and she has a kindness that might be rare in an Onco.

Good luck on your search .... and, of course, keep the faith! 

  I hope the Xtandi is or will do some good for your Dad. I am on my 7th day of Xtandi, too soon for another PSA test - but, at least, there have been no side effects that I can say were created recently.

  Another note - if finances of that drug are driving you up a wall, I do have some good news, and I hope to confirm a major manufacturer assistance program that is working this afternoon.

The very best to you ... and your Dad.