Lupron+Zytiga vs Lupron+Chemo

Thank you Peanut for the encouraging news! I have delved pretty deep into researching this already, and it seems in cases like ours treatment is trending toward more aggressive out of the gate. I like the idea of knocking it out early, especially when I hear stories like yours from two years down the road!

I am going to start a new topic as Michael suggested in order to garner more response. I will update there on our progress.

Side note: First Lupron injection today was uneventful (for me anyway!). But boy was that needle big!

Here's what the CHAARTED study reported after extended follow-up on early chemohormonal therapy in men with metastatic hormone-sensitive PC:

"For those with low-volume disease, no OS benefit was observed"

ascopubs.org/doi/10.1200/JCO.2017.75.3657

People throw around the term "aggressive" a lot --I know I have! But as we learn more about the natural history of prostate cancer, we learn that there are windows of opportunity in the disease's progression when different therapies become more or less effective. Chemo has never demonstrated any effectiveness in several studies of its use before RP, and its effect on radiosensitization was very small. The cancer in its less advanced state is just not susceptible to an antimitotic effect of the microtubule binding that taxanes do. It is only when metastases are more developed that the microtubule binding becomes fatal. Similarly, trials of Provenge before the cancer has become metastatic and castration-resistant have proven it to be completely ineffectual. Zytiga did not yet demonstrate any efficacy before there were metastases in hormone-sensitive men. It has recently shown efficacy in non-metastatic men who were already castration resistance. This demonstrates that these very toxic medicines each has its own place and time to be used - its Goldilocks moment. Using it too soon, only provides toxicity. Using it to late diminishes any survival benefit.