Dear JPAINTMAT,
Welcome to the forum --- and you are receiving a wide variety of replies, which is always helpful to see a range of responses, with various experiences ---
Just yesterday, I discussed this topic with my oncologist --- I have advanced prostate cancer, diagnosed in 2013 when I was in my 40s, with mets in both my lungs. My initial PSA was over 100 when I was first diagnosed. I've been on continuous ADT shots since 2013, have done a series of Taxotere chemotherapy treatments, and now on ZYTIGA. I've been on ZYTIGA for about
six months now, have seen some great results, and it brought my PSA lower than it had been when I was on the ADT shots plus the chemo treatments.
In recent months, many of us here with advanced cases have pursued the "early chemo" plan following a diagnosis for advanced stages of prostate cancer.
My oncologist and I discussed what the "next step" would be, now that I've gone through the "early chemo" plan and then went on ZYTIGA after that. There are some beginning signs that I might be becoming resistant to ZYTIGA, as we have seen some signs of my PSA "creeping up" the past couple of months. His plan for me would be that we will watch the PSA very carefully, stay on ZYTIGA as long as I possibly can, and then we would then give XTANDI a try --- hoping that I could get some additional help from XTANDI --- at least for a time.
Since I started first on ZYTIGA, it's the opposite situation that you inquired about
--- my next step likely being XTANDI --- my impression is that when it is determined that ZYTIGA is losing its effectiveness, then we would immediately switch over to XTANDI --- although I know that cross-resistance between the two medications is often the case. It seems that many patients in my situation end up trying both ZYTIGA and XTANDI, first one and then the other.
Down the road after that, my oncologist and I discussed that a second, longer series of chemo treatments would be the next sequential step in my care plan. I am encouraged by some recent reports that tell me that sometimes after a second series of chemo treatments, ZYTIGA or XTANDI can then be reintroduced, sometimes with effectiveness yet again in some patients. I hope that we hear more and more about
that in the future.
Medications like ZYTIGA and XTANDI are still relatively new, introduced in very recent years --- doctors and scientists are still learning more about
maximizing their effectiveness and which medication will work the best for each individual patient's medical case. Both of these medications are a huge step forward for treating advanced prostate cancer patients, and I'm thankful that they became available right before I was diagnosed. I hope that more breakthrough treatments and medications like these can become available soon for all of us in the battle, and for those diagnosed in the future.
Keep in touch with us here --- hoping that you get the medical answers that will help you the most with your case ! You can see from the range of responses that you are getting that you will find a lot of help and support right here !
Sent with my best,
"Cyclone" From Iowa State
Post Edited (ISU-CycloneFan) : 1/19/2016 9:12:44 PM (GMT-7)