Time to switch therapies after 6.5 years on HT . . . suggestions?

My last PSA this early August showed, once again, a rise, this time .6% points to 5.1. My onc and I both felt that it was time for some tests as I was also suffering from a long bout with deepening fatigue that, try what we might, nothing would shake it. The PSA had been rising about 1% point every 4 months, right along with my Lupron injections. I was also taking Casodex for the past 14 months which corresponded to the timing of the fatigue.

The tests she suggested were blood work for Vit. B12 deficiency and Thyroid deficiency. Also on order were a CT Scan, pelvis and chest, and a Bone Scan, whole body. The blood work showed significant Thyroid def. which points to the fatigue, the Vit. B12 was A-OK. The CT scan showed double pneumonia, upper right lobe and lower left lobe again consistent with the drag-ass fatigue. The Bone Scan was revealing . . . aggravated arthritis head to toe and new mets in my t4 anterior ribs. These were in addition to the ones found at Dx on my lumbar area ribs.

Therapies for the Thyroid and Pneumonia are pretty straight forward, Synthyroid for the former and a round of high test antibiotics for the latter as well as exercise. The arthritis calls for NSAIDs, stretching, and perhaps additional opioids as a palliative. Any other ideas would be welcome guys.

Now to the CRPCm. Dr. Karen suggested either Zytiga + Prednisone or Provenge. From my own research and also all of the anecdotal info you folks have provided me with I am really leaning towards Provenge. My ins. will cover it so that's not an issue, thank heavens . . . I also have had bad reactions to Prednisone in the past so I'm hesitant to go down that road again. I'm just about 59, 5' 11" and 185 with the casodex paunch and breasts that I'll be working off now that I don't have to take the Caso anymore, YAY! I'm fairly active with gardening and house chores so I'd say that I'm in ok shape and plan to stay that way. What I'd really like from you fellow sufferers is more anecdotes like what's with this portal deal? Does it stick out where it could get tangled up in the sheets and stuff like that. What are the SEs like? Well, that's enough for the first chapter of my Provenge journey . . . I sure appreciate having all of you to talk with . . . Q

Thanks Dev,
That was some cheering news. Like you said about your coming vacation from Lupron, even if its just in your head the thought feels great. I'm also gladdened by your endorsement of Synthroid, do you get the brand name or are the generic just the same? Might as well start out on the right foot . . . best of luck, least of pain . . . Q

Xtandi and Provenge in combination seems to offer promising results..



www.cafepharma.com/boards/showthread.php?t=527959

Quincy, I am a newbie on Lupron, only since 3-28-2013. So not in a positiion to offer you a lot of advice, but do have some.

With my G9 and bony mets metrics, someday I will be relying on your results to decide what path to take.

My radiation oncologist did mention Radioum 223 as a future possibility when my advanced PCa becomes resistant. It is FDA approved now and kind of a liquid radiation for bone mets.

I recently had MRIs of the thoracic spine and of the Sacroiliac. Though the MRIs confirmed the bone mets, the one which lit up the bone scan the most actually turned out to be a 4 MM benign herniated disc at T7-T8 with extrinsic compression of the right exiting root sleeve. Sounds pretty bad but no pain or other symptoms.

So the MRI report conclusion was that lesions are present involving the T4 and T9 vertebral bodies consistent with mild metastatic disease disease. No paraspinal masses are noted at these 2 levels.

To me mild met disease is like mild heart attack, it's only mild when it is somebody else.

Long way of saying if you have not already done so, supplement the bone scans with MRI's.

I will be praying for a great outcome for you, Quincy, whatever you decide.

LupronJim

Thanks putt,
I too have spent time in the chemo room and have witnessed the vein hunt, awful. As it is, my veins hardly stand up for a reg. blood test so I am definitely gonna be getting a port.
Hey Lupron Jim,
Thanks for the Lupron info. I will be taking your MRIadvice as the Provenge therapy moves along. As for you, how long have you been on Lupron? Are you having to take Casodex as well? To me, that was the worst part, how one tiny pill can screw your body up so bad is amazing. I gained 30 lbs. and grew painful breast buds over 9 months, YUCK! Any time you want advise on Lupron, I've got over 6years experience to draw on . . . Q

hi putt,
I can understand that. I'm going to have to have to go to a special onc unit 200 round trip miles just for the Provenge treatment. I don't know why my veins won't stand out during blood tests, I've had enough of them but they just don't. This last time I had to be poked two times for every gusher . . . Q