Enza: PSA down, ALPS up...?

Things get really stressful when the meds become almost trial and error.

The reduction in PSA is great and may be a combination of chemo continuing to work and enza boosting it. The ALP rise is probably due to those drugs having an impact on your Husband's liver albeit the level does usually come down when those drugs are stopped or reduced.

However it can also be caused by bone trauma of any kind, not necessarily mets but an imbalance in the natural bone cell death and regeneration process.

When you speak to the specialist at your review they might suggest introducing Zometa infusions every 3 weeks or so to help strengthen the bones.

They may also have a much better explanation for the ALP rise and offer other solutions if they don't think Zometa is a good option.

The main thing they will focus on is that your Husband is feeling well, managing chores and achieving a massive PSA reduction.

I hope you are well too, remember to look after your own self.

All the best

Xxxx

Mo

Thank you both for your thoughtful comments.

I can now report back to you, and to anyone else who happens to read this thread. It's all good news. The oncologist says the high ALP is probably a temporary flare, possibly caused by bone healing, and by a delay in the effect of the Enza. He expects it to go down again.

So we are left with a very positive response to Enzalutamide, plus the fact that Tony is feeling fit and well. He is going to start phasing out the painkillers now, and see how that goes. Zometa may be added in later to strengthen the bones, probably beginning in January, but it may not be as often as monthly after the first couple of infusions; perhaps every two or three months. Treatment with Radium 223 may be indicated later, but probably not until the Enza loses its effect.

So we are feeling very pleased and relieved that we can look forward to Christmas with no worrying tests or intrusive treatments getting in the way. Th overall prognosis is still bleak, but just the prospect of an extra few months' more of good quality life is very cheering. Today has been a good day!

Marje

Thanks, David. The constipation doesn't seem to be a problem since he stopped the codeine.

We have a home BP monitor, which seems to tally well with"official " readings. So far, Tony's BP is quite normal.

Today we drew up our own version of the chart you suggested to monitor progress. Tony didn't include all the variables in yours, but did add in weight, appetite, and BP, which may all link in with the other factors.

So thanks for the advice!
Marje

Really pleased to hear your news long may it continue

Enjoy the new year

Si x

After the initial worry I am so glad that things are settling.

BFN

Julie X

Great end of year boost for you and for all of us taking or about to take enzo! My journey starts late Jan, I hope I can get such a reaction. Enjoy new year!