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Abiraterone and / or chemotherapy

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Posted 10/23/2016 2:45 PM (GMT 0)
I have read a lot about abiraterone (zytiga) in the last few days. Does anyone know if this is now widely available to men in the UK (if the Drs believe it might be helpful) and if so does it tend to be given before or after chemo. I have also read about the trial which concluded that early chemo could be better so confused now re the order things are done in.

(My husband has been diagnosed with an initial PSA of other 6000. I am very scared that they will say nothing they can do but at same time trying to be hopeful that something will be able to control it)

Thank you.
Posted 10/23/2016 3:35 PM (GMT 0)
Sallyyy,

I have not read your other thread completely but you can be sure that your doctors will recommend ADT. This will bring down the PSA value A LOT. I will probably be corrected in this forum but I would not be surprised if the value would get below 20 ng/ml. Zytiga will be recommended by your doctors when your husband has had ADT for a while, i.e. a couple of years.

If it turns out that your husband has bone metastases the doctors should recommend a Chemo in addition to the ADT. It makes sense to do that early while your husband has not really suffered from the disease.

George
Posted 10/23/2016 5:45 PM (GMT 0)
Sallyy,

In the UK, Xtandi (enzalutamide), but not Zytiga (abiraterone), is approved for castration-resistant men who have not yet had chemotherapy. Castration-resistance means that PSA continues to rise while on first-line androgen deprivation therapy. In my opinion, Xtandi is a somewhat more effective hormonal drug.

Chemotherapy is a different decision. If the bone scan shows there are multiple metastases - 4 or more - at distant sites, Taxotere (docetaxel) has been shown to extend survival significantly.
Posted 10/24/2016 6:29 AM (GMT 0)
Hi Sal,
I know you must be going crazy waiting to see the oncologist. When is your DHs appt? Tall Allen knows his stuff. I hope there are no mets, but with a psa that high, I would think that's unlikely.
Is your hubby generally healthy?
If you want to create signature line with your husband's stats like most have, you just go in to "my profile" and follow the prompts. You can add to it as you begin tx, but you could start with his age and PSA.
Thinking of you and sending positive vibes across the miles to you.
Beth
Posted 10/25/2016 1:22 PM (GMT 0)
Hi Sal,

Xtandi is approved for chemo naïve patients. You could try the Xtandi first. If it works you will know rather quickly. I took it for a year before it failed (typical). It lowered my PSA immediately and backed up the lung mets to a point that I was not coughing up blood. Best I have felt since diagnosis eight years ago.

Yes, early chemo has been shown to be best. But chemo is difficult for some patients (like myself) and just another day (like Sonny) for others. My chemo has shrunk lung mets but bone mets continued to progress.

Try Xtandi or ZYtiga if you prefer. They are very similar drugs. If they are not effective you will likely know in a few months and they are not as hard on the patient.

Don
Posted 12/5/2016 12:18 AM (GMT 0)
Sally, give us some baseline markers..When was you husband diagnosed ? His Gleason score, age? Any primary treatments? They will start ADT first, which can have a dramatic effect and see how he responds to that..
Posted 12/8/2016 3:59 PM (GMT 0)
Sorry *Fairwind* - I have only just seen this reply.
My husband was diagnosed on the 11th October. He is 62 and the Gleason score is 9 (4+5). Initial PSA was 6000 then 6700 only a week later.
He is on 3 monthly zolodex (goserelin) injections and is on his 2nd cycle of docetaxel (2nd infusion yesterday.)
We are just waiting for his latest PSA result.
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