Xtandi Effectiveness

Vancouver, Canada

I'll try and keep it short. My father (10/44 ) had original PSA of 170 in March 2014
Started Lupron every 3 mos - It stayed down to 5 until 15 months and then went up to 13, 26
Changed urologists since we moved so we started 6 months ( Eligard ) in Nov 2015
Checked again in Dec, and went upto 33
Dad was recommended Clinical Trial, so by time we checked PSA in Feb again for trial, it went upto 79
Started xtandi in Feb - PSA down to 75.55 in Feb End
Contd xtandi, now its 76.30

Its from the exact same lab - I was hoping it would have gone down but only bright thing I see it's not gone terribly up, unsure what clinical trial people might say - would they continue or put em in Zytiga
They said no chemo for now, as he is in good shape

My Dad - 71
No side effects till date
No issue urinating
Works as a gas stn attendant 6 days a week

They said saw a small spot in Liver but not much to worry as xtandi should take care of it

My query is if PSA went up from 75.55 to 76.30 - can this e margin of error, or it takes time to go down in the long run?
He also takes biphosphonates apart from Calcium, Vitamin D ( Doc said look into Xgeva but its $500/mo and BC Cancer doesnt cover that - unsure if that will be super benefecial )

Thoughts, opinions/ thanx

Sorry, yes bone mets is there but he never had issues. We did bone density scan too, but not after biphosphonates

As for chemo, they said its an option but it will make him weak so they want to put it in side pocket

My very old post - https://www.healingwell.com/community/default.aspx?f=35&m=3143151&g=3143937#m3143937

I have appt this Friday, I'll talk to em - I have met atleast 2 urologists who said no to chemo and even the oncologist- as their understanding was it might make him weaker and if he is healthy then it can be taken later as the effect now or them would be same
He takes biphosphonate pills once a week ( Fosamax ) as Xgeva is not covered by Cancer Agnecy, it's an out of pocket 500/month, but I have heard some saying the difference is not that much and side effect from xgeva can be bad. So I don't know what to do there

Dear Prem,

We all extend our greetings to you in Canada ! It's very evident that you have a strong concern for your father's health and well-being --- we are here to help you and support you. The bond that you have with your father is important --- he's going to need you, and your post shows us that you are there for him, every step of the way.

I can tell from your posts, current and past, that you are an advocate for your father and his health. With the higher PSA when he was diagnosed and the metastatic spread to his bones when he was first diagnosed, he needs continuous and aggressive treatments --- find the best doctors you can find for your father, and advocate for the best treatments you can.

We have other friends here who hail from Canada, and from them, we have learned that the Canadian healthcare system is organized in a different way than what is found here in the United States. So, we will all do our best to support you and advise you ... from across the miles ...

Since the release of the CHAARTED study and the STAMPEDE study, doctors here have now implemented what we nickname the "early chemo plan" for those of us with advanced prostate cancer. These studies emerged in recent years and QUICKLY changed the protocol for how advanced prostate cancer cases were handled --- years ago, chemo treatments were reserved as a "last resort" after everything else failed ---

Over time, these clinical studies showed a very favorable survival advantage when chemo infusions were given to patients EARLY after a diagnosis of advanced prostate cancer. There are quite a few of us fellows right here on this forum who have undergone the "early chemo" treatment infusions --- when this new plan started, we had some members here who had to become their own STRONG ADVOCATES with their doctors and insist that chemo treatments be implemented for their advanced cases. Now, this has become a very standardized treatment protocol across the United States ---

I know that some of our members from Canada ended up paying for their own chemo treatments "out of pocket" when they were denied these treatments by the Canadian healthcare system. I wonder if chemo treatments could be provided for your father from some national program that allows for compassionate medical care for advanced cancer cases in Canada ?

The CHAARTED study and the STAMPEDE study clearly showed survival advantages for implementing chemo infusions early in the treatment sequence. I would write down the names of both of these studies and show them to your father's doctors at your upcoming consultation. You might need to become the strong advocate for him, insisting that chemo treatments be considered now, rather than later.

Undergoing chemo treatments is an individual decision that needs to be made in close consultation with doctors. However, it's important to state that many of us here went through chemo treatments, had relatively mild side effects, kept very active, continued with our full-time careers, and kept up with our family, friends, and social life during the chemo treatments. Your father's doctors would want to watch over him very carefully if he pursues chemo treatments, but your father could quite possibly continue his work that you told about in your post --- and continue to stay active during chemo treatments.

All of us here are thinking about you and your father --- we all want the very best for him right now --- please have a very honest visit with your father's doctors about the importance of considering chemo treatments, based on the details you listed about his case. It's an important topic of discussion, and we all want to make sure that your father has the chance to pursue every available treatment option that would help him the very most --- currently, and looking to the future, as well.

Thanks for posting here with us, Prem. This forum definitely has a global scope, with members hailing from ALL corners of the globe --- so we are here to support you and your father in Canada --- please let us know how your father's next consultation goes --- and most of all, I want to thank you for all the care and support you are showing to your father right now. I am very sure that the support you are showing each day means the WORLD to him !

Sent with my best to you, from across the miles, to Canada ~
"Cyclone Team Fan" From Iowa State University

In addition to what T.A. said, if the Xtandi is not working, you might try switching to Zytiga..Sometimes one gives a better response than the other...